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

Yong Lin; Jun Yuan; Quanxin Long; Jieli Hu; Haijun Deng; Zhenyu Zhao; Juan Chen; Mengji Lu; Ailong Huang

doi:10.1016/j.gendis.2020.11.005

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

Genes Dis. 2021 Jul;8(4):484-492. doi: 10.1016/j.gendis.2020.11.005. Epub 2020 Nov 18.

Authors

Yong Lin¹, Jun Yuan², Quanxin Long¹, Jieli Hu¹, Haijun Deng¹, Zhenyu Zhao¹, Juan Chen¹, Mengji Lu³, Ailong Huang¹

Affiliations

¹ Key Laboratory of Molecular Biology of Infectious Diseases (Chinese Ministry of Education), Chongqing Medical University, Chongqing, 400016, PR China.
² School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, PR China.
³ Institute for Virology, University Hospital of Essen, University of Duisburg-Essen, Essen, 45122, Germany.

Abstract

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-CoV-2 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.

Keywords: ALP, alkaline phosphatase; ALT, alanine aminotransferase; AST, aspartate aminotransferase; Abnormal liver function; COVID-19; COVID-19, coronavirus disease 2019; GGT, gamma-glutamyltransferase; HBV; HBV, hepatitis B virus; IQR, interquartile range; Inactive HBV carriers; LDH, lactate dehydrogenase; Liver injury; SARS-CoV-2; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; TBIL, total bilirubin.