Retrospective Cohort Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Feb 27, 2024; 16(2): 211-228
Published online Feb 27, 2024. doi: 10.4254/wjh.v16.i2.211
Effects of SARS-CoV-2 infection on incidence and treatment strategies of hepatocellular carcinoma in people with chronic liver disease
Lung-Yi Mak, Matthew Shing Hin Chung, Xue Li, Francisco Tsz Tsun Lai, Eric Yuk Fai Wan, Celine Sze Ling Chui, Franco Wing Tak Cheng, Esther Wai Yin Chan, Ching Lung Cheung, Ivan Chi Ho Au, Xi Xiong, Wai-Kay Seto, Man-Fung Yuen, Carlos King Ho Wong, Ian Chi Kei Wong
Lung-Yi Mak, Matthew Shing Hin Chung, Xue Li, Wai-Kay Seto, Man-Fung Yuen, Department of Medicine, The University of Hong Kong, Hong Kong, China
Lung-Yi Mak, Wai-Kay Seto, Man-Fung Yuen, State Key Laboratory of Liver Research, The University of Hong Kong, Hong Kong, China
Matthew Shing Hin Chung, Xue Li, Francisco Tsz Tsun Lai, Eric Yuk Fai Wan, Franco Wing Tak Cheng, Esther Wai Yin Chan, Ching Lung Cheung, Ivan Chi Ho Au, Xi Xiong, Carlos King Ho Wong, Ian Chi Kei Wong, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong, China
Xue Li, Francisco Tsz Tsun Lai, Eric Yuk Fai Wan, Celine Sze Ling Chui, Esther Wai Yin Chan, Ching Lung Cheung, Carlos King Ho Wong, Ian Chi Kei Wong, Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Hong Kong, China
Eric Yuk Fai Wan, Carlos King Ho Wong, Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
Celine Sze Ling Chui, School of Nursing, The University of Hong Kong, Hong Kong, China
Celine Sze Ling Chui, Ivan Chi Ho Au, School of Public Health, The University of Hong Kong, Hong Kong, China
Ian Chi Kei Wong, Research Department of Practice and Policy, University College London, London WC1E 6BT, United Kingdom
Ian Chi Kei Wong, Aston School of Pharmacy, Aston University, Birmingham B4 7ET, United Kingdom
Co-first authors: Lung-Yi Mak and Matthew Shing Hin Chung.
Co-corresponding authors: Carlos King Ho Wong and Ian Chi Kei Wong.
Author contributions: Mak LY, Chung MSH, Wong CKH reviewed the literature, conducted analyses, contributed to the interpretation of the analysis, and wrote the manuscript; Mak LY, Li X, Wong CKH reviewed the literature, designed the study and statistical analysis. Chung MSH, Au ICH, Xiong X conducted analyses. Mak LY, Li X, Lai FTT, Wan EYF, Chui CSL, Cheng FWT, Chan EW, Cheung CL, Seto WK, Yuen MF, Wong CKH, Wong ICK contributed to the interpretation of the analysis. Mak LY, Wong CKH and Wong ICK were responsible for the study concept. Both Wong CKH and Wong ICK have played important and indispensable roles in the study design, data interpretation and manuscript preparation as the co-corresponding authors. Wong CKH and Wong ICK conceptualized, designed, and supervised the whole process of the project. Wong CKH reviewed the literature and was instrumental for statistical analysis. Wong ICK applied for and obtained the funds for this research project, and contributed to the interpretation of the analysis. This collaboration between Wong CKH and Wong ICK is crucial for the publication of this manuscript. All authors contributed to the interpretation of the analysis, critically reviewed and revised the manuscript, and approved the final manuscript as submitted. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.
Supported by Collaborative Research Fund Scheme, University Grants Committee, No. C7154-20GF; and Data Discovery for Health (D24H); Innovation and Technology Commission, AIR@InnoHK.
Institutional review board statement: The study protocol was approved by the Institutional Review Board of the University of Hong Kong/ Hospital Authority Hong Kong West Cluster (UW 20-556, UW 21-149 and UW 21-138); and the Department of Health Ethics Committee (LM 21/2021 and LM 175/2022).
Informed consent statement: Informed patient consent was not required as the data used in this study were anonymised.
Conflict-of-interest statement: Lung-Yi Mak is an advisory board member for Gilead Sciences. Xue Li has received research grants from the Health Bureau of the Government of the Hong Kong SAR, research and educational grants from Janssen and Pfizer; internal funding from the University of Hong Kong; consultancy fee from Merck Sharp & Dohme, unrelated to this work. Francisco Tsz Tsun Lai has been supported by the RGC Postdoctoral Fellowship under the Hong Kong Research Grants Council and has received research grants from the Health Bureau of the Government of the Hong Kong SAR, outside the submitted work. Eric Yuk Fai Wan has received research grants from the Health Bureau of the Government of the Hong Kong SAR, and the Hong Kong Research Grants Council, outside the submitted work. Celine Sze Ling Chui has received grants from the Health Bureau of the Hong Kong Government, Hong Kong Research Grant Council, Hong Kong Innovation and Technology Commission, Pfizer, IQVIA, and Amgen; personal fee from Primevigilance Ltd.; outside the submitted work. Esther Wai Yin Chan reports honorarium from the Hospital Authority, grants from the Research Grants Council (RGC, Hong Kong), Research Fund Secretariat of the Health Bureau, National Natural Science Fund of China, Wellcome Trust, Bayer, Bristol-Myers Squibb, Pfizer, Janssen, Amgen, Takeda, and Narcotics Division of the Security Bureau of the Hong Kong SAR, outside the submitted work. Ching Lung Cheung received research grants and honorarium from Amgen, research grant support from HMRF, and honorarium from Abbott. Wai Kay Seto received speaker's fees from AstraZeneca and Mylan, is an advisory board member of CSL Behring, is an advisory board member and received speaker's fees from AbbVie, and is an advisory board member, received speaker's fees, and researching funding from Gilead Sciences. Man-Fung Yuen serves as advisor/consultant for AbbVie, Assembly Biosciences, Aligos Therapeutics, Arbutus Biopharma, Bristol Myer Squibb, Clear B Therapeutics, Dicerna Pharmaceuticals, Finch Therapeutics, GlaxoSmithKline, Gilead Sciences, Immunocore, Janssen, Merck Sharp and Dohme, Hoffmann-La Roche, and Springbank Pharmaceuticals, Vir Biotechnology and receives grant/research support from Assembly Biosciences, Aligos Therapeutics, Arrowhead Pharmaceuticals, Bristol Myer Squibb, Fujirebio Incorporation, Gilead Sciences, Immunocore, Merck Sharp and Dohme, Hoffmann-La Roche, Springbank Pharmaceuticals, and Sysmex Corporation, outside the submitted work. Carlos King Ho Wong reports receipt of research funding from the EuroQoL Group Research Foundation, the Hong Kong Research Grants Council, the Hong Kong Health and Medical Research Fund, AstraZeneca and Boehringer Ingelheim, all outside of the submitted work. Ian Chi Kei Wong reports research funding outside the submitted work from Amgen, Bristol-Myers Squibb, Pfizer, Janssen, Bayer, GSK, Novartis, the Hong Kong RGC, and the Hong Kong Health and Medical Research Fund, National Institute for Health Research in England, European Commission, National Health and Medical Research Council in Australia. All other authors declare no competing interests.
Data sharing statement: The data that support the findings of this study were provided by the Hong Kong Hospital Authority. Restrictions apply to the availability of these data, which were used under license for this study.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Carlos King Ho Wong, BSc, MPhil, PhD, Assistant Professor, Department of Pharmacology and Pharmacy, The University of Hong Kong, 2/F, 21 Sassoon Road, Li Ka Shing Faculty of Medicine, Laboratory Block, Faculty of Medicine Building, Hong Kong, China. carlosho@hku.hk
Received: December 1, 2023
Peer-review started: December 1, 2023
First decision: December 12, 2023
Revised: December 31, 2023
Accepted: January 30, 2024
Article in press: January 30, 2024
Published online: February 27, 2024
Processing time: 88 Days and 3.3 Hours
Core Tip

Core Tip: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with chronic liver disease (CLD) leads to worse adverse clinical outcomes. In our study, we found that although CLD patients with SARS-CoV-2 infection did not have higher risk of developing liver cancer, they are more likely to receive palliative treatment for hepatocellular carcinoma, compared to CLD patients who did not have SARS-CoV-2 infection. Coronavirus disease 2019 also led to increased risks of all-cause mortality and adverse hepatic outcomes. These detrimental effects of SARS-CoV-2 infection were observed in both acute and post-acute phases among CLD patients.