HBV coinfection and in-hospital outcomes for COVID-19: a systematic review and meta-analysis

ABSTRACT

Background Since December 2019, there are 30 million confirmed cases of a novel coronavirus disease (COVID-19) secondary to severe acute respiratory syndrome coronavirus 2. As of 2020, hepatitis B virus (HBV) affects more than 200 million people worldwide. Both are caused by viral agents. The short-term mortality rate from COVID-19 is much higher than that of HBV. Objective We sought to understand the impact of HBV coinfection on hospitalized patients with COVID-19. Search Methods Searches of the literature were conducted in the PubMed, Cochrane Library, and Embase electronic databases. Selection Criteria We included cohort studies and randomized studies with information on rates of mortality and intensive care unit (ICU) admission from individuals coinfected by HBV and COVID-19. Data Collection and Analysis Data from six cohort studies with 2,015 patients were collected between January and April 2020, and the results were analyzed by meta-analysis. Main Results HBV coinfection did not lead to increased mortality or ICU admission rates among individuals hospitalized for COVID-19 (risk ratio 0.79, 95% CI 0.333–1.83, N = 2,015;adjusted OR = 0.79, 95% CI 0.31–1.98). During their hospital stay, coinfected patients did not appear to have an increased hospital length of stay or risk of hepatitis B reactivation. Conclusions This systematic review and meta-analysis provides support that HBV is not a significant risk factor for serious adverse outcomes among patients hospitalized for COVID-19 infection.