Clinical characteristics of coronavirus disease 2019 patients with hepatitis B virus super-infection

Abstract

COVID-19 and hepatitis B disease are significant global pandemics, both of which can lead to liver damage. This study aims to report the clinical course of liver function and disease prognosis of COVID-19 patients with hepatitis B virus (HBV) super-infections. A total of 249 outpatients with COVID-19 were enrolled in this study from December 1, 2023 to February 28, 2024. Clinical characteristics, laboratory data, chest CT findings, and patients’ treatment and outcomes were collected and analyzed retrospectively. Of the 249 outpatients, 37 (14.9%) were super-infected with HBV, whereas 212 (85.1%) showed no such outcome. This study found no significant differences between the two groups regarding age, gender, symptoms, complications, or chest CT findings. However, COVID-19 patients super-infected with HBV showed lower white blood cell, neutrophil, and platelet counts ( p < 0.05). Additionally, total bilirubin levels were significantly higher in the SARS-CoV-2/HBV super-infected group compared to the COVID-19-only group ( p = 0.022). After the first week of similar treatment, both groups showed almost identical outcomes, including hospitalization, severity, and mortality rates. Thus, SARS-CoV-2/HBV super-infection slightly affected liver function but did not worsen COVID-19 outcomes. Routine HBV monitoring and liver function tests are recommended to manage COVID-19 patients with HBV super-infections. This study found no clear indications of the need to change the therapeutic prescription for COVID-19 in cases of HBV super-infections.