key: cord-276565-vkbu581j
authors: He, Qing; Zhang, Guo; Gu, Ye; Wang, Jitao; Tang, Qiyuan; Jiang, Zicheng; Shao, Chuxiao; Zhang, Hongguang; Chen, Zhenhuai; Ma, Baoyi; Liu, Dengxiang; Xie, Guanghang; Xu, Dan; Huang, Yifei; Zhang, Haijun; Liang, Mingkai; Huang, Huihong; Wang, Yan; Liu, Hongyan; Yang, Jie; Pan, Hongqiu; Zou, Shengqiang; Li, Fujian; Wang, Fang; Liu, Chuan; Wang, Wenjuan; Xiong, Bin; Li, Xun; Liu, Lei; Yang, Jianrong; Qi, Xiaolong
title: Clinical Characteristics of COVID-19 Patients With Pre-existing Hepatitis B Virus Infection: A Multicenter Report
date: 2020-09-11
journal: Am J Gastroenterol
DOI: 10.14309/ajg.0000000000000924
sha: 
doc_id: 276565
cord_uid: vkbu581j

nan

Coronavirus disease 2019 (COVID-19) has become a global challenge since December 2019 (1) . Of the 99 patients with COVID-19 in Wuhan, 43 (43.4%) had differing degrees of liver function abnormality (1) . Therefore, liver disease in COVID-19 attracted widespread concern (2). There are no data yet focusing on the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with underlying liver disease, such as hepatitis B virus (HBV) infection. To date, 257 million people are living with HBV infection worldwide (3) . Thus, it is indispensable to study the clinical characteristics of COVID-19 patients with preexisting HBV infection.

Data were obtained from a cohort (coronavirus disease 2019-hepatitis B virus-Chinese Portal Hypertension Diagnosis and Monitoring Study Group, COVID-HBV-CHESS) to consecutively monitor COVID-19 patients in 10 designed hospitals of 8 provincial administrative regions in China ( Figure 1a ). Patients were hospitalized from January 10, 2020, to February 20, 2020, with a final follow-up on April 2, 2020. This study was approved by all ethics commissions, with a waiver of written informed consent. As of April 2, we have collected and analyzed 571 cases diagnosed with laboratoryconfirmed SARS-CoV-2 infection by real-time fluorescence polymerase chain reaction. Fifteen (2.63%) of 571 patients had a history of HBV infection that seems to be lower than the incidence of HBV infection in the overall Chinese population (5.7%) (3). There were no cases with cirrhosis diagnosed by either clinical findings and/or liver biopsy in the cohort. Of them, 3 (20.00%) of 15 patients had a history of antiviral treatment (entecavir), and all had suppression of the HBV. The mean age of COVID-19 positive patients with pre-existing HBV infection was 45.80 years (SD, 11.06), and 10 (66.67%) were men. The common symptoms at onset of illness were fever (9 [60.00%]), dry cough (7 [46.67%]), and diarrhea (2 [ Figure 1b) .

In the COVID-HBV-CHESS study, we analyzed the clinical characteristics of COVID-19 patients with pre-existing HBV infection for the first time, to our best knowledge; only by multicenter analysis can we follow-up COVID-19 with underlying liver disease, such as HBV infection. We found that patients with pre-existing HBV infection might have a lower incidence of intensive care unit admission or death, and similar findings were reported in severe acute respiratory syndrome (SARS) coronavirus with HBV coinfection during the outbreak of SARS in 2003 (4). Our hypothesis of the mechanism of this protective effect might be mediated by host immune responses (5) on the indirect interplay between HBV and SARS-CoV-2. However, the study was limited with a 

Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study

Liver injury in COVID-19: Management and challenges

Accelerating the elimination of viral hepatitis: A Lancet Gastroenterology & Hepatology Commission

Clinical significance of hepatic derangement in severe acute respiratory syndrome

Dominance of hepatitis C virus (HCV) is associated with lower quantitative hepatitis B surface antigen and higher serum interferong-induced protein 10 levels in HBV/HCVcoinfected patients

National Clinical Research Center for Infectious Diseases, the Third People's Hospital of Shenzhen, the Second Affiliated Hospital of

Department of Infectious Diseases and Critical Care Medicine, the Affiliated Third Hospital of Jiangsu University, Zhenjiang, China; 8 Department of Respiratory Medicine, the People's Hospital of Baoding, Baoding, China; 9 Department of Respiratory Medicine, the People's Hospital of LinXia Hui Prefecture

Correspondence: Xiaolong Qi, MD. E-mail: qixiaolong@vip.163.com