key: cord-0904264-md9adq3l
authors: Lv, Xiu-He; Yang, Jin-Lin; Deng, Kai
title: Clinical outcomes of COVID-19 patients with chronic hepatitis B virus infection still need to be explored
date: 2020-08-11
journal: Clin Gastroenterol Hepatol
DOI: 10.1016/j.cgh.2020.07.068
sha: 86dbfc43fc316c50fb812ea13194e2ad2a9618c4
doc_id: 904264
cord_uid: md9adq3l

nan

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Dear Editor:

We read with great interest of the study written by Zou et al 1 . Their results are interesting and important, but we do have some concerns about it.

In this study, the authors found that liver injury in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and chronic hepatitis B virus (HBV) co-infection was associated with severe illness and an overall poor prognosis.

However, these results are built on a single cohort, meaning that COVID-19 patients with HBV co-infection have not been compared with patients with SARS-CoV-2 infection alone. One of the major concerns for clinicians is whether COVID-19

patients with a specific disease have a more severe illness and a worse prognosis than those without, which is not provided in the current study.

In terms of the data presented in this study, the results of HBV-DNA test have not been given and therefore the clinical stage of included patients cannot be determined clearly. Because most patients in this study are likely to be classified as patients with

HBeAg-negative chronic HBV infection 2 , the clinical outcomes of patients with acute HBV infection or with active HBV replication remain unclear. Furthermore, the authors described the information of patients who took oral antivirals on admission. It is not clear whether these patients continued to take antivirals during hospitalization, which may affect patients' clinical outcomes. We also found that many antivirals, antibiotics and steroids were used for treatment in this study, and the use of these drugs may further influence the results; drug-induced liver injury cannot be ruled out in this study 3 . influence the disease progression in COVID-19 patients. Since the current study did not present data on patients' immune function, more research is needed to confirm this hypothesis and explain the specific mechanism in the future.

European Association for the Study of the Liver