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Causal associations between chronic hepatitis B and COVID-19 in East Asian populations

Zhenguo Liu1, Linnan Song1, Junling Chen1

  • 1State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, No. 1838 North Guangzhou Avenue, Guangzhou, 510515, China.

Virology Journal
|June 1, 2023
PubMed

Insights

Chronic hepatitis B (CHB) increases the risk of SARS-CoV-2 infection and COVID-19 hospitalization. This study utilized Mendelian randomization to establish a causal link, offering insights into COVID-19 susceptibility and severity.

Area of Science:

  • Genetics and Infectious Diseases
  • Epidemiology
  • Public Health

Background:

  • Observational studies show inconsistent associations between chronic hepatitis B (CHB) and Coronavirus disease 2019 (COVID-19).
  • Mendelian randomization (MR) is employed to investigate potential causal relationships, overcoming limitations of traditional observational studies.

Purpose of the Study:

  • To determine the total and direct causal associations between CHB and COVID-19 outcomes.
  • To assess if CHB influences susceptibility and severity of COVID-19 infections.

Main Methods:

  • Univariate and multivariate Mendelian randomization (MR) analyses were conducted.
  • Genome-wide association study (GWAS) datasets for CHB and COVID-19 were utilized from the Japan Biobank and COVID-19 Host Genetics Initiative.
  • Sensitivity analyses were performed to ensure result reliability.

Main Results:

  • Univariate MR indicated CHB significantly increases the risk of SARS-CoV-2 infection, hospitalized COVID-19, and severe COVID-19.
  • Multivariable MR, after adjusting for factors like type 2 diabetes and BMI, confirmed CHB's positive association with SARS-CoV-2 infection and hospitalized COVID-19.
  • The causal link between CHB and severe COVID-19 was attenuated in multivariable MR; no causal effect of COVID-19 on CHB was found.

Conclusions:

  • Chronic hepatitis B is causally linked to increased susceptibility and severity of COVID-19.
  • Findings are particularly relevant for individuals of East Asian ancestry.
  • The study highlights the importance of considering CHB status in COVID-19 risk assessment.
Abstract

Keywords:
Causal effectChronic hepatitis B (CHB)Coronavirus disease 2019 (COVID-19)Mendelian randomization (MR)

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