Background & Aims
We compared risk of acute liver injury and mortality in COVID‐19 patients with current, past, and no hepatitis B virus (HBV) infection.
Approach & Results
This was a territory‐wide retrospective cohort study in Hong Kong. COVID‐19 patients between 23 January 2020 and 1 January 2021 were identified. Patients with hepatitis C or no hepatitis B surface antigen results were excluded. The primary outcome was mortality. Acute liver injury was defined as alanine aminotransferase or aspartate aminotransferase ≥2x upper limit of normal (ULN) (i.e. 80U/L), with total bilirubin ≥2xULN (i.e. 2.2mg/dL) and/or international normalized ratio ≥1.7. Of 5,639 patients included, 353 (6.3%) and 359 (6.4%) had current and past HBV infection, respectively. Compared to patients without known HBV exposure, current HBV‐infected patients were older, and more likely to have cirrhosis. Past HBV‐infected patients were the oldest, and more had diabetes and cardiovascular disease. At a median follow‐up of 14 (9–20) days, 138 (2.4%) patients died; acute liver injury occurred in 58 (1.2%), 8 (2.3%), and 11 (3.1%) patients with no, current, and past HBV infection, respectively. Acute liver injury (adjusted hazard ratio [aHR] 2.45, 95% CI 1.52–3.96, P<0.001), but not current (aHR 1.29, 95% CI 0.61–2.70, P=0.507) or past HBV infection (aHR 0.90, 95% CI 0.56–1.46, P=0.681), was associated with mortality. Corticosteroid, antifungal, ribavirin, and lopinavir‐ritonavir use (adjusted odds ratio [aOR] ranged from 2.55–5.63), but not current (aOR 1.93, 95% CI 0.88–4.24, P=0.102) or past HBV infection (aOR 1.25, 95% CI 0.62–2.55, P=0.533), were associated with acute liver injury.
Conclusion
Current or past HBV infections were not associated with more liver injury and mortality in COVID‐19.
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May 08, 2021 at 10:08AM
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Current and past infections of hepatitis B virus do not increase mortality in patients with COVID‐19 - Wiley
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