Hbv coinfection and in-hospital outcomes for covid-19: A systematic review and meta-analysis

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.