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. 2022 Jun;11(3):1229-1242.
doi: 10.1007/s40121-022-00638-4. Epub 2022 Apr 26.

Patients with COVID-19 and HBV Coinfection are at Risk of Poor Prognosis

Shanshan Yang #  1   2 , Shengshu Wang #  2   3 , Mingmei Du #  1 , Miao Liu  4   5 , Yunxi Liu  6 , Yao He  7
Affiliations

Patients with COVID-19 and HBV Coinfection are at Risk of Poor Prognosis

Shanshan Yang et al. Infect Dis Ther. 2022 Jun.

Abstract

Introduction: This study aimed to determine whether there is a difference in the risk of death/critical illness between different stages of hepatitis B virus (HBV) (resolved hepatitis B, HBeAg (-) chronic hepatitis B [CHB]/infection, HBeAg (+) CHB/infection, and HBV reactivation) coinfected with coronavirus disease 2019 (COVID-19); and if there is a difference, whether it is due to abnormal liver function and to what extent.

Methods: This cohort study included all COVID-19 inpatients of a single-center tertiary care academic hospital in Wuhan, Hubei, China, between February 4, 2020, and follow-up to April 14, 2020. A total of 2899 patients with COVID-19 were included as participants in this study, and they were divided into five groups based on hepatitis B infection status. Follow-up was conducted for mortality and ICU admission during hospitalization.

Results: The median follow-up time was 39 days (IQR, 30-50), with 66 deaths and 126 ICU admissions. After adjustment, compared with patients without CHB, the hazard ratio (HR) for ICU admission was 1.86 (95% CI: 1.05-3.31) for patients with HBeAg (+) CHB/infection. The HR for death was 3.19 (95% CI: 1.62-6.25) for patients with HBeAg (+) CHB/infection. The results for the mediating effect indicated that the total effect of HBeAg (+) CHB/infection on death/ICU stay was partially mediated by abnormal liver function, which accounted for 79.60% and 73.53%, respectively.

Conclusion: Patients with COVID-19 coinfected with HBV at the HBeAg (+) CHB/infection stage have an increased risk of poor prognosis, and abnormal liver function partially mediates this increased risk of poor prognosis caused by the coinfection.

Keywords: COVID-19; Coinfection; Hepatitis B virus; Prognosis.

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Figures

Fig. 1
Fig. 1
Flow diagram of the study population
Fig. 2
Fig. 2
Survival curve stratified by different HBV infection status groups among all COVID-19 patients: survival time against overall survival probability
Fig. 3
Fig. 3
The simple mediating effects of abnormal liver function between HBeAg (+) CHB/infection (x-axis) and poor prognosis (y-axis). Graph A represents death, and graph B represents ICU admission, respectively. Effect values refer to unstandardized regression coefficients
See this image and copyright information in PMC

References

    1. Huang C, Huang L, Wang Y, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet (Lond, Engl) 2021;397(10270):220–232. doi: 10.1016/s0140-6736(20)32656-8. - DOI - PMC - PubMed
    1. Tian L, Qiang T, Liang C, et al. RNA-dependent RNA polymerase (RdRp) inhibitors: the current landscape and repurposing for the COVID-19 pandemic. Eur J Med Chem. 2021;213:113201. doi: 10.1016/j.ejmech.2021.113201. - DOI - PMC - PubMed
    1. Sharma A, Ahmad-Farouk I, Lal SK. COVID-19: a review on the novel coronavirus disease evolution, transmission, detection, control and prevention. Viruses. 2021;13:2. doi: 10.3390/v13020202. - DOI - PMC - PubMed
    1. Chang MS, Nguyen MH. Epidemiology of hepatitis B and the role of vaccination. Best Pract Res Clin Gastroenterol. 2017;31(3):239–247. doi: 10.1016/j.bpg.2017.05.008. - DOI - PubMed
    1. Schweitzer A, Horn J, Mikolajczyk RT, Krause G, Ott JJ. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet (Lond, Engl) 2015;386(10003):1546–1555. doi: 10.1016/s0140-6736(15)61412-x. - DOI - PubMed

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