COVID-19乙型肝炎病毒感染患者的臨床特徵-回顧性研究

StephenW

Clinical Characteristics of COVID-19 Patients with Hepatitis B Virus Infection - a Retrospective Study
Rui Liu  1 , Li Zhao  2 , Xiaoming Cheng  3 , Han Huan  1 , Cong Li  2 , Dong Li  1 , Andrew Liu  4 , Guosheng Gao  5 , Feng Zhou  6 , Fang Liu  7 , Yingan Jiang  8 , Chengliang Zhu  1 , Yuchen Xia  2
Affiliations
Affiliations

    1
    Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China.
    2
    State Key Laboratory of Virology and Hubei Province Key Laboratory of Allergy and Immunology, Institute of Medical Virology, School of Basic Medical Sciences, Wuhan University, Wuhan, China.
    3
    National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 20892, USA.
    4
    Frank H. Netter MD School of Medicine, Quinnipiac University, North Haven, USA.
    5
    Department of Clinical Laboratory, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, P.R. China.
    6
    Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Hubei Clinical Center and Key Laboratory for Intestinal and Colorectal Diseases, Wuhan, 430071, China.
    7
    State Key Laboratory of Virology, College of Life Sciences, Wuhan University, Wuhan, 430072, China.
    8
    Department of Infectious Diseases, Renmin Hospital, Wuhan University, Wuhan, China.

    PMID: 33351265 DOI: 10.1111/liv.14774

Abstract

Background & aims: The outbreak of coronavirus disease 2019 (COVID-19) has been declared a pandemic. Although COVID-19 is caused by infection in the respiratory tract, extrapulmonary manifestations including dysregulation of the immune system and hepatic injury have been observed. Given the high prevalence of hepatitis B virus (HBV) infection in China, we sought to study the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and HBV coinfection in patients.

Methods: Blood samples of 50 SARS-CoV-2 and HBV coinfected patients, 56 SARS-CoV-2 mono-infected patients, 57 HBeAg-negative chronic HBV patient controls and 57 healthy controls admitted to Renmin Hospital of Wuhan University were collected in this study. Complete blood count and serum biochemistry panels including markers indicative of liver functions were performed. Cytokines including IFN-γ, TNF-α, IL-2, IL-4, IL-6 and IL-10 were evaluated. T cell, B cell and NK cell counts were measured using flow cytometry.

Results: SARS-CoV-2 and HBV coinfection did not significantly affect the outcome of the COVID-19. However, at the onset of COVID-19, SARS-CoV-2 and HBV coinfected patients showed more severe monocytopenia and thrombocytopenia as well as more disturbed hepatic function in albumin production and lipid metabolism. Most of the disarrangement could be reversed after recovery from COVID-19.

Conclusions: While chronic HBV infection did not predispose COVID-19 patients to more severe outcomes, our data suggests SARS-CoV-2 and HBV coinfection poses a higher extent of dysregulation of host functions at the onset of COVID-19. Thus, caution needs to be taken with the management of SARS-CoV-2 and HBV coinfected patients.

Keywords: COVID-19; hepatitis B; liver damage; monocytopenia; thrombocytopenia.

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StephenW

COVID-19乙型肝炎病毒感染患者的臨床特徵-回顧性研究
劉瑞1，李昭2，成曉明3，韓歡1，叢麗2，董麗1，劉德華4，國盛高5，馮州6，劉芳7，應安江8，朱成良1，夏雨霞2
隸屬關係
隸屬關係

    1個
    武漢大學人民醫院臨床實驗室，武漢
    2
    武漢大學基礎醫學院，醫學病毒學研究所，病毒學國家重點實驗室和湖北省變態反應與免疫學重點實驗室，武漢，中國。
    3
    美國國立衛生研究院糖尿病與消化及腎臟疾病研究所，美國20892。
    4
    美國北尼文市昆尼皮亞克大學醫學博士Frank H. Netter。
    5
    中國科學院大學附屬華美醫院臨床檢驗科，寧波
    6
    武漢大學中南醫院消化內科，湖北省臨床中心，腸道及大腸疾病重點實驗室，武漢430071
    7
    武漢大學生命科學學院病毒學國家重點實驗室，武漢430072
    8
    武漢大學人民醫院傳染病科，武漢

    PMID：33351265 DOI：10.1111 / liv.14774

抽象

背景與目的：2019年冠狀病毒病（COVID-19）的爆發已被宣佈為大流行病。儘管COVID-19是由呼吸道感染引起的，但已觀察到肺外表現，包括免疫系統異常和肝損傷。鑑於中國的乙肝病毒（HBV）感染率很高，我們試圖研究重症急性呼吸綜合徵冠狀病毒2（SARS-CoV-2）和HBV合併感染對患者的影響。

方法：收集武漢大學人民醫院收治的50例SARS-CoV-2和HBV合併感染患者，56例SARS-CoV-2單一感染患者，57例HBeAg陰性慢性HBV患者對照和57例健康對照者的血樣。研究。進行了全血細胞計數和包括指示肝功能標記的血清生化檢測。評價了包括IFN-γ，TNF-α，IL-2，IL-4，IL-6和IL-10的細胞因子。使用流式細胞儀測量T細胞，B細胞和NK細胞計數。

結果：SARS-CoV-2和HBV合併感染並未顯著影響COVID-19的預後。但是，在COVID-19發作時，SARS-CoV-2和HBV合併感染的患者顯示出更嚴重的單血細胞減少症和血小板減少症，以及在白蛋白生成和脂質代謝中肝功能受損的情況。從COVID-19中恢復後，大多數紊亂都可以逆轉。

結論：雖然慢性HBV感染並未使COVID-19患者有更嚴重的預後，但我們的數據表明SARS-CoV-2和HBV合併感染在COVID-19發作時對宿主功能的異常調節作用更大。因此，在治療SARS-CoV-2和HBV合併感染的患者時要格外小心。

關鍵字：COVID-19；乙型肝炎；肝損害;單核細胞減少症血小板減少症。

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