Patients with SARS-CoV-2 and HBV co-infection are at risk of greater liver injury

To date, it remains unclear if severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) co-infection exacerbates liver injury in patients with chronic hepatitis B virus (HBV) infection. In this study, we present a retrospective study of 133 hospitalized confirmed mild coronavirus disease 2019 (COVID-19) cases, including 116 patients with COVID-19 with negative serum hepatitis B antigen and 17 HBV inactive carriers with COVID-19. We found that there were no significant differences for the discharge rate or duration of hospitalization between the two groups. However, inactive HBV carriers with SARS-CoV-2 co-infection are at a higher risk of abnormal liver function tests. The enhanced liver injury induced by SARS-CoV2 and HBV co-infection was identified as the hepatocyte type rather than the cholangiocyte type. Moreover, the inflammatory response, including abnormal lactate dehydrogenase, D-dimer and interleukin-6 production, may contribute to this injury following SARS-CoV-2 co-infection. Collectively, SARS-CoV-2 and HBV co-infection exacerbates liver function of the patients with COVID-19. Copyright (C) 2020, Chongqing Medical University. Production and hosting by Elsevier B.V.

Automated summary

This study showed that patients with chronic HBV infection and SARS-CoV-2 co-infection are at higher risk of abnormal liver function tests. However, there were no significant differences in discharge rate or hospitalization duration between the two groups. Enhanced liver injury induced by the co-infection may be related to hepatocyte involvement and inflammatory response.