The investigators of the present study contrasted the risk of acute liver injury and mortality in patients with COVID-19 and current, past, and no HBV infection.

This territory-wide retrospective cohort study included patients with COVID-19 between January 23, 2020, and January 1, 2021. Exclusion criteria were patients with hepatitis C or no HBsAg results. The primary outcome was mortality. Acute liver injury was typified as alanine aminotransferase or aspartate aminotransferase ≥2 × upper limit of normal (ULN; i.e., 80 U/L), with total bilirubin ≥2 × ULN (i.e., 2.2 mg/dL) and/or international normalized ratio ≥1.7.

The outcome of the study demonstrated that among 5,639 patients included, 353 (6.3%) and 359 (6.4%) had current and past HBV infection, respectively. Current HBV-infected patients were older and had higher probability of having cirrhosis in contrast to patients without known HBV exposure. Past HBV-infected patients were the oldest, and more had diabetes and cardiovascular disease. Moreover, at a median follow-up of 14 days, 138 (2.4%) patients died; acute liver injury happened in 58 (1.2%), 8 (2.3%), and 11 (3.1%) patients with no, current, and past HBV infection, respectively. Acute liver injury (adjusted HR [aHR], 2.45; 95% CI, 1.52-3.96), but not current (aHR, 1.29; 95% CI, 0.61-2.70) or past (aHR, 0.90; 95% CI, 0.56-1.46) HBV infection, was correlated to mortality. Administration of corticosteroid, antifungal, ribavirin, or lopinavir–ritonavir (adjusted OR [aOR], 2.55-5.63), but not current (aOR, 1.93; 95% CI, 0.88-4.24) or past (aOR, 1.25; 95% CI, 0.62-2.55) HBV infection, was related to acute liver injury.

The study summarized that current or past HBV infections were not correlated to more liver injury and mortality in COVID-19.

Source: Cheuk-Fung YT, Wai-Sun WY, Chung-Yan LG, et al. Current and Past Infections of HBV Do Not Increase Mortality in Patients With COVID-19. 2021. Available at: https://aasldpubs.onlinelibrary.wiley.com/doi/10.1002/hep.31890