J Korean Med Sci.  2022 Jan;37(4):e29. 10.3346/jkms.2022.37.e29.

Clinical Effect of Hepatitis B Virus on COVID-19 Infected Patients: A Nationwide Population-Based Study Using the Health Insurance Review & Assessment Service Database

• Choe JW
• Jung YK
• Yim HJ
• Seo GH

• KMID: 2525010
• DOI: http://doi.org/10.3346/jkms.2022.37.e29

Abstract

Background
Several studies have recently suggested that liver disease and cirrhosis were risk factors for poor outcomes in patients with coronavirus disease 2019 (COVID-19) infections. However, no large data study has reported the clinical course of COVID-19 patients with chronic hepatitis B virus (HBV) infections. This study investigated whether HBV infection had negative impacts on the clinical outcomes of COVID-19 patients.
Methods
We performed a nationwide population-based cohort study with 19,160 COVID-19-infected patients in 2020 from the Korean Health Insurance Review and Assessment database. The clinical outcomes of COVID-19 patients with chronic HBV infections were assessed and compared to those of non-HBV-infected patients.
Results
Of the 19,160 patients diagnosed with COVID-19, 675 (3.5%) patients had chronic HBV infections. The HBV-infected patients were older and had more commodities than the non-HBV infected COVID-19 patients. During the observation period, COVID-19-related mortality was seen in 1,524 (8.2%) of the non-HBV-infected 18,485 patients, whereas 91 (13.5%) in HBV-infected 675 patients died of COVID-19 infection. Compared to patients without HBV infections, a higher proportion of patients with chronic HBV infections required intensive care unit (ICU) admission and had organ failures. However, odds ratios for mortality, ICU admission, and organ failure were comparable between the two groups after adjusting for age, sex, and comorbid diseases including liver cirrhosis and hepatocellular carcinoma.
Conclusion
COVID-19-infected patients with HBV infections showed worse clinical courses than non-HBV-infected COVID-19 patients. However, after adjustment, chronic HBV infection itself does not seem to affect the clinical outcomes in COVID-19 patients.

Keyword

Coronavirus Disease 2019; Chronic Hepatitis B; Risk Factor; SARS-CoV-2; Coronavirus; COVID-19; Antiviral

Figure

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  Fig. 1 Kaplan-Meier curve of overall survival in COVID-19-infected patients compared according to HBV infection status. The HBV-infected patients were divided into those treated with or without anti-viral agents.COVID-19 = coronavirus disease 2019, HBV = hepatitis B virus.

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