COVID-19 in patients with pre-existing chronic liver disease – predictors of outcomes

Table 4 Studies showing outcomes and predictors of severity in hepatitis B virus-infected patients with coronavirus disease 2019

Ref.	Study	Patients	Results	Predictors
Yang et al[38]	Single centre retrospective study	Patients with HBV infection out of 2899 COVID patients. Resolved hepatitis B (n = 503); HBeAg (-) CHB/infection (n = 44); HBeAg (+) CHB/infection (n = 55); HBV reactivation (n = 6)	HBeAg (+) CHB/infection and HBV reactivation were associated with more abnormal liver function, severe disease, longer ICU stay, and death	Increased ICU admission (HR: 1.86) and mortality (HR: 3.19) in HBeAg (+) CHB/infection
Choe et al[40]	Nationwide population-based cohort study	676 chronic HBV infection cases (19160 COVID-19 cases)	Mortality in HBV infected vs non-infected patients with COVID-19: 8.2% vs 13.5%	No difference in mortality, ICU admission, or organ failure
Wang et al[8]	Multicentre retrospective cohort study	109 CHB and 327 non-CHB patients with COVID-19	CHB vs non-CHB patients: Severe disease (27.5% vs 12.84%) and more dyspnoea (55.05% vs 43.12%) and mechanical ventilation requirement (22.49% vs 7.95%) in CHB	Increased mortality in CHB patients (OR: 3.748). Predictors of mortality: AST; ALT; ALP; Bilirubin; LDH; Elevated D-dimer. Protective effect: ALB (HR: 0.13); ALB/GLO (HR: 0.123)
Yip et al[44]	Retrospective cohort study	Current (353) and past HBV infection (359) out of total 5639 COVID cases	Mortality in current HBV vs past HBV vs non-HBV infection: 2.3% vs 5.8% vs 2.2%	Acute liver injury associated with mortality (aHR: 2.45), more than current (aHR: 1.29) or past (aHR: 0.90) HBV infection
Kang et al[42]	Nationwide cohort study	7723 COVID-19 cases and 46231 controls	Lower SARS-CoV-2 positivity rate in CHB, after adjusting for comorbidities (aOR: 0.65)	Reduced SARS-CoV-2 positivity (aOR: 0.49) on antivirals
Liu et al[39]	Retrospective cohort study	347 COVID-19 patients (21 vs 326 with or without chronic HBV infection)	Severe COVID-19 in 30% vs 31.4% in the HBV vs non-HBV group	Similar SARS-CoV-2 clearance and severe COVID-19

ALB: Albumin; ALP: Alkaline phosphatase; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; COVID: Coronavirus disease; CHB: Chronic hepatitis B; GLO: Globulin; HBV: Hepatitis B virus; LDH: Lactate dehydrogenase.