Longitudinal Changes of Liver Function and Hepatitis B Reactivation in COVID‐19 Patients with Pre‐existing Chronic HBV Infection

Liu, Jiaye; Wang, Tingyan; Cai, Qingxian; Sun, Liqin; Huang, Deliang; Zhou, Guangde; He, Qing; Wang, Fu‐Sheng; Liu, Lei; Chen, Jun

AIM: With pandemic of COVID‐19 currently and high endemic of chronic HBV infection worldwide, it is quite urgent to investigate liver function changes of COVID‐19 patients with chronic HBV infection, and how SARS‐CoV‐2 infection in turn affects the course of chronic HBV infection. METHOD: We conducted a retrospective study based on 347 COVID‐19 patients (21 vs. 326 with vs. without chronic HBV infection). With the PSM method, we yielded 20 and 51 matched patients for HBV group and non‐HBV group, respectively. RESULTS: At the end of follow‐up, all these 71 patients achieved SARS‐CoV‐2 clearance (p=0.1). During the follow‐up, 30% vs. 31.4% in HBV group vs. non‐HBV group progressed to severe COVID‐19 (p=0.97). After PSM, the longitudinal changes of median values for liver biochemistries were no significant difference between two groups. In HBV group vs. non‐HBV‐group, 35% (7/20) vs. 37.25% (19/51) (p = 0.86) had abnormal ALT at least once during hospitalization, while 30% (6/20) vs. 31.37% (16/51) for abnormal AST (p = 0.91), 40% (8/20) vs. 37.25% (19/51) for abnormal GGT (p = 0.83), and 45% (9/20) vs. 39.22% (20/51) for abnormal TBIL (p = 0.91). Moreover, 3 patients in HBV group had hepatitis B reactivation. CONCLUSIONS: Liver dysfunction presented in COVID‐19 patients with/without chronic HBV. Moreover, those COVID‐19 patients coinfected with chronic HBV could had a risk of hepatitis B reactivation. It is necessary to monitor liver function of COVID‐19 patients, as well as HBV DNA levels for those coinfected with HBV during the whole disease course.