Epidemiological and Clinical Characteristics of 70 Cases of Coronavirus Disease and Concomitant Hepatitis B Virus Infection

A Multicentre Descriptive Study

Jian Wu; Jiong Yu; Xiaowei Shi; Wei Li; Shu Song; Liangping Zhao; Xinguo Zhao; Jun Liu; Dawei Wang; Chengyuan Liu; Biao Huang; Yiling Meng; Bin Jiang; Yijun Deng; Hongcui Cao; Lanjuan Li


J Viral Hepat. 2020;28(1):80-88. 

In This Article

Patients and Methods


A total of 620 eligible COVID-19 patients, who were referred to the Fifth People's Hospital of Wuxi City, Wuhan Central Hospital, Tongji Medical College, Huazhong University of Science and Technology, the Second People's Hospital of Fuyang City, Taizhou Enze Medical Center (Group) Enze Hospital, the First People's Hospital of Yancheng City, the Second People's Hospital of Yancheng City, and the First Affiliated Hospital of Wenzhou Medical University from January 20, 2020 to March 20, 2020, were screened to be included in the groups, COVID-19 without HBV infection (WHI group, n = 550) and COVID-19 combined with HBV infection (CHI group, n = 70). The patient enrolment flowchart is shown in Figure 1. This study was performed in accordance with the Helsinki Declaration and was approved by the Ethics Committee of the Fifth People's Hospital of Wuxi City (Approval number: 2020-002-1).

Figure 1.

The flow chart for enrolled patient with COVID-19

Definition of cases

All the enrolled cases met the criteria of the World Health Organization (WHO).[21] The cases were defined on the basis of epidemiologic profile, consistency with any two clinical manifestations and pathogenic evidence, as previously described,[22] including the definition of clinical classifications. Considering the number of patients in the CHI group, the disease types were divided into two groups: (1) mild group (including mild and moderately severe cases) and (2) severe group (including severe and critically ill cases). COVID-19 patients were defined on the basis of their epidemiological profile as follows: first generation (Generation I), patients with a history of exposure in the South China Seafood Market in Wuhan, China; second generation (Generation II), patients with a history of travel in Wuhan; third generation (Generation III), patients with imported cases, and fourth generation (Generation IV) patients with history of contact with Generation III patients.

In this study, all COVID-19 patients with other concomitant viral infections, drug-induced liver injury, and/or with underlying diseases, such as cardiovascular disease and diabetes mellitus, were excluded. SARS-CoV-2 RNA testing was conducted using three samples of nasal, pharyngeal and anal swabs by real-time polymerase chain reaction (PCR).[22]

Data Collection

For all participants, we collected and analysed demographic and epidemiologic data (exposure to infected areas, contact with confirmed or suspected COVID-19 patients, clustering, and so on), laboratory parameters, radiologic imaging results, outcome and treatment records. Following admission, all the patients underwent routine laboratory investigations, including routine complete blood count, blood biochemistry, virologic examination for liver disease and coagulation function All the data were collected on the first day after admission. Clinical outcomes were followed up until March 20, 2020.

Statistical Analysis

All statistical analyses were performed using SPSS (v.22.0; SPSS Inc). Continuous data were expressed as mean ± standard deviations and were analysed using the Student's t test. A value of P < .05 was considered statistically significant. Univariate and multivariate logistic regression analyses were performed to evaluate the risk factors for delayed recovery of patients with COVID-19 and concomitant HBV infection.