Severity and Mortality in Covid-19 With Hepatitis B Co-Infection A Systematic Review and Meta-Analysis

Abstract

Utsav Vaghani, Vatsalkumar Jetani, Ishita Sanghani, Vidit Jogani, Niralkumar Ghevariya, Devangkumar Lakhani and Akash Patel

This systematic review and meta-analysis investigate the severity and mortality in COVID-19 patients co- infected with Hepatitis B Virus (HBV). Utilizing established databases and adhering to PRISMA guidelines, 15 studies were included after a rigorous selection and data extraction process, with quality assessed using the Newcastle–Ottawa Scale (NOS). Statistical analysis was conducted using Review Manager (RevMan) software. The findings indicate a significantly higher risk of severe clinical outcomes and mortality in COVID-19 patients with HBV co-infection compared to those without HBV. Among patients with both HBV and COVID-19, 30.2% developed severe clinical outcomes, compared to 19.5% in COVID-19 patients without HBV. Mortality rates were also higher in the co-infected group (4.9%) compared to those with only COVID-19 (3.4%). The study notes considerable heterogeneity among the included studies, as indicated by high I2 values. These results align with previous findings on the impact of chronic liver diseases on COVID-19 outcomes but contrast with some studies suggesting a potential protective effect of HBV. The analysis also considers the complexities of managing COVID-19 in HBV patients, particularly the risks associated with corticosteroid therapy and HBV reactivation, while acknowledging limitations such as variability in methodologies and potential publication biases. The study underscores the heightened severity and mortality risks for COVID-19 patients with HBV co-infection, emphasizing the need for tailored management strategies and further research into the mechanisms and optimal treatment protocols for this patient population.

PDF