Seroprevalence of hepatitis B and C viruses in moderate and severe COVID-19 inpatients: A cross-sectional study at a referral center in Mexico.

INTRODUCTION AND OBJECTIVES: The emergence of SARS-CoV-2, which causes the coronavirus disease (COVID-19) has caused a great impact on healthcare systems worldwide, including hepatitis B and C viruses screening and elimination programs. The high number of COVID-19 hospitalizations represent a great opportunity to screen patients for hepatitis B virus (HBV) and hepatitis C virus (HCV), which was the aim of this study. MATERIAL AND METHODS: Cross-sectional, retrospective study performed between April 2020 and 20201 at a referral center in Mexico dedicated to the care of adults with severe/critical COVID-19. We retrieved clinical, demographic, and laboratory results from each patient´s medical records, including antibodies against HCV (anti-HCV), HBV surface antigen (HBsAg), antibodies against the HBV core antigen (anti-HBcAg), and antibodies against HBsAg (anti-HBsAg). RESULTS: Out of 3620 patients that were admitted to the hospital, 24 (0.66%), 4 (0.11%), and 72 (1.99%) tested positive for anti-HCV, HBsAg, and anti-HBcAg, respectively. Of all seronegative patients, 954 (27%) had undetectable anti-HBsAg and 401 (12%) had anti-HBsAg at protective levels. Blood transfusion was the most relevant risk factor. Only 9.7% of the anti-HBc positive, 25% of the HBsAg positive, and 52% of the anti-HCV positive were aware of their serological status. CONCLUSIONS: In this study we found a prevalence of anti-HCV of 0.66%, HBsAg in 0.11%, and isolated anti-HBcAg in 1.99%. We also found that HBV vaccination coverage has been suboptimal and needs to be reinforced. This study gave us a trustworthy insight of the actual seroprevalence in Mexico, which can help provide feedback to the Hepatitis National Elimination Plan.

Hepatic and gastrointestinal manifestations of SARS-COV-2 infection (COVID-19)

Background and aim: Abnormal liver function tests (LFTs) and gastrointestinal (GI) symptoms have been reported up to 50% in patients with COVID-19, and in 5% they can precede respiratory symptoms. The objective of this work is to describe the LFTs and GI symptoms of patients with COVID-19 and their association with admission to the intensive care unit (ICU) and mortality. Material and Methods. We conducted a retrospective, cross sectional, descriptive study, using files from patients with a positive Gen Finder COVID-19 test, admitted to Medica Sur Clinic and Foundation between March 13th through May 14th, 2020. We performed descriptive analysis of data and its association with clinical outcomes. Results: A total of 108 patients with COVID-19 were identified;68.5% (n = 74) were men, the mean age was 53 ± 14 years and the body mass index was 28.6 ± 5.8 kg/m2. The most frequent comorbidity was hypertension with 24% (n = 26). The presence of comorbidities was associated with risk of ICU admission (OR 3.9 [95% CI 1.6-9.9], p = 0.002). The most frequent symptoms were cough (72.2%, n = 78), fever (69.4%, n = 75) and dyspnea (48.1%, n = 52). At least one abnormal LFT was present in 94% (n = 103) of patients at admission, the most frequent was LDH (88.9%, n = 96), AST and GGT (63%, n = 65), which are summarized in Table 1. Patients presented abnormal LFTs and respiratory symptoms in 48.1% (n = 52), while 16.6% (n = 18) presented abnormal LFTs without respiratory symptoms. Among GI symptoms, 37% (n = 4) reported at least one, including diarrhea (28.7%, n = 31), hyporexia (9.3%, n = 10), nausea (8.3%, n = 9) or vomiting (4.6%, n = 5). Of patients admitted to the ICU (n = 39), 27.5% (n = 10) presented at least one GI symptom. Mortality was 7.4% (n = 8). No associations were found between abnormal LFTs, GI symptoms, and outcomes of mortality and ICU admission. Conclusions: In patients with COVID 19, the presence of metabolic comorbidities confers a higher risk of ICU admission, in contrast to abnormal LFTs and GI symptoms that were not associated with clinical outcomes. Conflicts of interest: The authors have no conflicts of interest to declare.