Yu Shan, Song Cunzheng
Shanghai Jiao Tong University School of Medicine, Ren Ji Hospital, Department of Infectious Diseases, Shanghai, China.
Shanghai University of Traditional Chinese Medicine, Shuguang Hospital, Shanghai, China.
Rev Inst Med Trop Sao Paulo. 2024 Dec 16;66:e74. doi: 10.1590/S1678-9946202466074. eCollection 2024.
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.
新冠病毒病和乙型肝炎都是重大的全球大流行病，两者均可导致肝损伤。本研究旨在报告乙型肝炎病毒（HBV）重叠感染的新冠病毒病患者的肝功能临床病程及疾病预后。2023年12月1日至2024年2月28日，本研究共纳入249例新冠病毒病门诊患者。对临床特征、实验室数据、胸部CT检查结果以及患者的治疗情况和结局进行回顾性收集和分析。在这249例门诊患者中，37例（14.9%）为HBV重叠感染，而212例（85.1%）未出现此类情况。本研究发现，两组在年龄、性别、症状、并发症或胸部CT检查结果方面无显著差异。然而，HBV重叠感染的新冠病毒病患者的白细胞、中性粒细胞和血小板计数较低（p<0.05）。此外，与仅感染新冠病毒的组相比，严重急性呼吸综合征冠状病毒2/ HBV重叠感染组的总胆红素水平显著更高（p=0.022）。经过第一周的类似治疗后，两组的结局几乎相同，包括住院率、严重程度和死亡率。因此，严重急性呼吸综合征冠状病毒2/ HBV重叠感染对肝功能有轻微影响，但并未使新冠病毒病的结局恶化。建议对HBV重叠感染的新冠病毒病患者进行常规HBV监测和肝功能检查。本研究未发现HBV重叠感染病例中有明确迹象表明需要改变新冠病毒病的治疗处方。
