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Clinical characteristics and risk factors of COVID-19 patients with chronic hepatitis B: a multi-center retrospective cohort study

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单位: [1]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Dept Urol,Wuhan 430030,Peoples R China [2]Huazhong Univ Sci & Technol, Tongji Med Coll, Sch Publ Hlth, Dept Epidemiol & Biostat,Key Lab Environm & Hlth, Wuhan 430030, Peoples R China [3]Wuhan Univ, Dept Resp & Crit Care Med, Renmin Hosp, Wuhan 430060, Peoples R China [4]Wuhan Ctr Dis Prevent & Control, Dept Virol, Wuhan 430024, Peoples R China [5]Huazhong Univ Sci & Technol, Tongji Med Coll, Inst Reprod Hlth, Wuhan 430030, Peoples R China [6]Zunyi Med Univ, Sch Nursing, Zunyi 563099, Guizhou, Peoples R China [7]Huazhong Univ Sci & Technol, Minist Educ, Key Lab Environm & Hlth, Wuhan 430030, Peoples R China [8]Huazhong Univ Sci & Technol, Minist Environm Protect, Wuhan 430030, Peoples R China [9]Huazhong Univ Sci & Technol, State Key Lab Environm Hlth Incubating, Sch Publ Hlth, Tongji Med Coll, Wuhan 430030, Peoples R China [10]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Dept & Inst Infect Dis,Wuhan 430030,Peoples R China [11]Wuhan Pulm Hosp, Dept Respirol & TB Specialty, Wuhan 430030, Peoples R China [12]Zunyi Med Univ, Affiliated Zhuhai Hosp 5, Zhuhai 519199, Peoples R China [13]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Dept Crit Care Med,Wuhan 430030,Peoples R China [14]Wuhan Jinyintan Hosp, Dept Radiol, Wuhan 430048, Peoples R China [15]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Dept Oncol,Wuhan 430030,Peoples R China [16]Huazhong Univ Sci & Technol, Tongji Med Coll, Dept Immunol, Wuhan 430030, Peoples R China [17]Univ Oulu, Fac Biochem & Mol Med, Bioctr Oulu, Oulu 90014, Finland [18]Huazhong Univ Sci & Technol,Tongji Med Coll,Tongji Hosp,Hepat Surg Ctr,Wuhan 430030,Peoples R China
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关键词: COVID-19 chronic hepatitis B liver injury coagulation dysfunction

摘要:
The Coronavirus disease 2019 (COVID-19) has spread globally. Although mixed liver impairment has been reported in COVID-19 patients, the association of liver injury caused by specific subtype especially chronic hepatitis B (CHB) with COVID-19 has not been elucidated. In this multi-center, retrospective, and observational cohort study, 109 CHB and 327 non-CHB patients with COVID-19 were propensity score matched at an approximate ratio of 3:1 on the basis of age, sex, and comorbidities. Demographic characteristics, laboratory examinations, disease severity, and clinical outcomes were compared. Furthermore, univariable and multivariable logistic and Cox regression models were used to explore the risk factors for disease severity and mortality, respectively. A higher proportion of CHB patients (30 of 109 (27.52%)) developed into severe status than non-CHB patients (17 of 327 (5.20%)). In addition to previously reported liver impairment markers, such as alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and total bilirubin, we identified several novel risk factors including elevated lactate dehydrogenase (> 245 U/L, hazard ratio (HR) = 8.639, 95% confidence interval (CI) = 2.528-29.523; P < 0.001) and coagulation-related biomarker D-dimer (> 0.5 mu g/mL, HR = 4.321, 95% CI = 1.443-12.939; P = 0.009) and decreased albumin (< 35 g/L, HR = 0.131, 95% CI = 0.048-0.361; P < 0.001) and albumin/globulin ratio (< 1.5, HR = 0.123, 95% CI = 0.017-0.918; P = 0.041). In conclusion, COVID-19 patients with CHB were more likely to develop into severe illness and die. The risk factors that we identified may be helpful for early clinical surveillance of critical progression.

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出版当年[2021]版:
大类 | 3 区 医学
小类 | 3 区 肿瘤学 3 区 医学:研究与实验
最新[2025]版:
大类 | 2 区 医学
小类 | 2 区 医学:内科 2 区 医学:研究与实验 2 区 肿瘤学
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出版当年[2020]版:
Q2 ONCOLOGY Q2 MEDICINE, RESEARCH & EXPERIMENTAL
最新[2023]版:
Q2 MEDICINE, RESEARCH & EXPERIMENTAL Q2 ONCOLOGY

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第一作者单位: [1]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Dept Urol,Wuhan 430030,Peoples R China
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