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

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.