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Updated: Dec 18, 2025
Author Spotlight: Advancements and Challenges in Hepatitis B Virus Detection
Published on: December 15, 2023
A case series of COVID-19 patients with chronic hepatitis B virus infection
Yang Li1, Chunyang Li2,3, Jian Wang4
1Department of Infectious Diseases, Taizhou People's Hospital, Taizhou, China.
Insights
Coronavirus disease 2019 (COVID-19) can affect liver function in patients with chronic hepatitis B virus (HBV) infection. This case series found liver function abnormalities but no severe complications in COVID-19 patients with chronic HBV.
Area of Science:
- Hepatology
- Infectious Diseases
- Virology
Background:
- Previous studies indicate coronavirus disease 2019 (COVID-19) can cause liver injury.
- Limited research exists on COVID-19's impact on liver function in individuals with chronic liver diseases, specifically chronic hepatitis B virus (HBV) infection.
Purpose of the Study:
- To describe the clinical characteristics and liver function of hospitalized COVID-19 patients coinfected with chronic HBV.
- To assess the severity of liver injury and complications in this patient cohort.
Main Methods:
- Retrospective case series including confirmed hospitalized COVID-19 patients with chronic HBV infection from 10 cities in Jiangsu province, China.
- Data extracted included demographics, epidemiological details, clinical features, laboratory results (ALT, AST, albumin, platelet count), and treatment.
- Inclusion criteria: confirmed COVID-19 and chronic HBV infection, hospitalized between January 18 and February 26, 2020.
Main Results:
- Seven patients with COVID-19 and chronic HBV infection were included; 85.7% were male, aged 33-49 years.
- Two patients had HBV-related cirrhosis; one was positive for HBV e-antigen.
- On admission, 14.3% had elevated ALT and 14.3% had elevated AST. During hospitalization, 42.9% had elevated ALT and 28.6% had elevated AST, with peak levels of 51 U/L (ALT) and 44 U/L (AST).
- Two patients with cirrhosis showed decreased albumin and platelet counts. No patients required ICU admission or developed liver failure. All patients were discharged by February 29, 2020.
Conclusions:
- Liver function abnormalities are relatively common in patients with COVID-19 and chronic HBV infection.
- Despite potential abnormalities, severe liver-related complications were not observed in this case series during hospitalization.
Abstract:
Previous studies reported that coronavirus disease 2019 (COVID-19) was likely to result in liver injury. However, few studies reported the impacts of COVID-19 on liver function in patients with chronic liver diseases. We aimed to describe a case series of COVID-19 patients with chronic hepatitis B virus (HBV) infection. Confirmed hospitalized COVID-19 patients from hospitals in 10 cities of Jiangsu province, China, were retrospectively included between 18 January 2020 and 26 February 2020. Demographic information, epidemiologic data, clinical features, and treatment data were extracted from medical records. Seven COVID-19 patients with chronic HBV infection were included. Six (85.7%) patients were male. The patients aged from 33 to 49 years. Two patients had HBV-related cirrhosis. One patient (14.3%) was positive for serum HBV e-antigen. On admission, 1 (14.3%) patient had mildly elevated alanine aminotransferase (ALT) level (>40 U/L) and 1 (14.3%) had elevated aspartate aminotransferase (AST) level (>40 U/L). The serum albumin level and platelet counts were decreased in two patients with HBV-related liver cirrhosis. Three (42.9%) patients had elevated ALT level and 2 (28.6%) patients had elevated AST level in hospitalization. However, the peak ALT and AST level during hospitalization was 51 U/L and 44 U/L, respectively. As of 29 February 2020, all patients were discharged. No patient was admitted to the intensive care units or developed liver failure during hospitalization. The abnormalities of liver function are not uncommon on COVID-19 patients with chronic HBV infection in our case series. However, no patient developed severe liver-related complications during hospitalization.
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