Hepatitis B associated with severe COVID-19: a nationwide cohort study in Sweden
Abstract Purpose Individuals with severe liver disease are more vulnerable to severe COVID-19, but the association between chronic hepatitis B virus (HBV) infection and severe COVID-19 remains unclear. This study evaluates this relationship. Methods We analysed nationwide Swedish data from national...
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| Format: | Article |
| Language: | English |
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BMC
2025-04-01
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| Series: | Virology Journal |
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| Online Access: | https://doi.org/10.1186/s12985-025-02743-5 |
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| author | Frida Jakobsson Osvaldo Fonseca-Rodríguez Hanna Jerndal Sebastian Kalucza Soo Aleman Marie Eriksson Anne-Marie Fors Connolly |
| author_facet | Frida Jakobsson Osvaldo Fonseca-Rodríguez Hanna Jerndal Sebastian Kalucza Soo Aleman Marie Eriksson Anne-Marie Fors Connolly |
| author_sort | Frida Jakobsson |
| collection | DOAJ |
| description | Abstract Purpose Individuals with severe liver disease are more vulnerable to severe COVID-19, but the association between chronic hepatitis B virus (HBV) infection and severe COVID-19 remains unclear. This study evaluates this relationship. Methods We analysed nationwide Swedish data from national databases and healthcare registers, identifying laboratory-confirmed COVID-19 cases from February 2020 to April 2021. Chronic HBV infection was classified into cases with and without cirrhosis. Multivariable logistic regression assessed the association between HBV and severe COVID-19, adjusting for demographics, comorbidities, vaccination, and socioeconomic factors. Results Among 1,057,174 COVID-19 cases, 2,902 had chronic HBV infection, which was associated with increased risk of severe COVID-19 (adjusted odds ratio [aOR] 1.242, 95% confidence interval [CI] 1.097–1.403). This risk was significantly higher in HBV individuals with cirrhosis (aOR 2.463, CI 1.546–3.892) compared to those without cirrhosis (aOR 1.183, CI 1.039–1.343). While overall COVID-19 mortality was not significantly elevated in the HBV cohort, patients with cirrhosis showed a higher, though nonsignificant, mortality risk (aOR 2.350, CI 0.921–5.203). Conclusion This nationwide study highlights an increased risk of severe COVID-19 in individuals with chronic HBV, particularly those with cirrhosis. Geographic and socioeconomic factors further influence outcomes. These findings underscore the need to consider HBV status in COVID-19 risk assessments. Future studies should explore these associations in the context of evolving SARS-CoV-2 variants and widespread vaccination. |
| format | Article |
| id | doaj-art-4745eb706fb74792a8dabc3f1235ec7b |
| institution | Kabale University |
| issn | 1743-422X |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Virology Journal |
| spelling | doaj-art-4745eb706fb74792a8dabc3f1235ec7b2025-08-20T03:52:23ZengBMCVirology Journal1743-422X2025-04-0122111010.1186/s12985-025-02743-5Hepatitis B associated with severe COVID-19: a nationwide cohort study in SwedenFrida Jakobsson0Osvaldo Fonseca-Rodríguez1Hanna Jerndal2Sebastian Kalucza3Soo Aleman4Marie Eriksson5Anne-Marie Fors Connolly6Department of Clinical Microbiology, Umeå UniversityDepartment of Clinical Microbiology, Umeå UniversityDepartment of Clinical Microbiology, Umeå UniversityDepartment of Clinical Microbiology, Umeå UniversityDepartment of Medicine, Huddinge Karolinska InstitutetDepartment of Statistics, Economics and Statistics, Umeå School of Business, Umeå UniversityDepartment of Clinical Microbiology, Umeå UniversityAbstract Purpose Individuals with severe liver disease are more vulnerable to severe COVID-19, but the association between chronic hepatitis B virus (HBV) infection and severe COVID-19 remains unclear. This study evaluates this relationship. Methods We analysed nationwide Swedish data from national databases and healthcare registers, identifying laboratory-confirmed COVID-19 cases from February 2020 to April 2021. Chronic HBV infection was classified into cases with and without cirrhosis. Multivariable logistic regression assessed the association between HBV and severe COVID-19, adjusting for demographics, comorbidities, vaccination, and socioeconomic factors. Results Among 1,057,174 COVID-19 cases, 2,902 had chronic HBV infection, which was associated with increased risk of severe COVID-19 (adjusted odds ratio [aOR] 1.242, 95% confidence interval [CI] 1.097–1.403). This risk was significantly higher in HBV individuals with cirrhosis (aOR 2.463, CI 1.546–3.892) compared to those without cirrhosis (aOR 1.183, CI 1.039–1.343). While overall COVID-19 mortality was not significantly elevated in the HBV cohort, patients with cirrhosis showed a higher, though nonsignificant, mortality risk (aOR 2.350, CI 0.921–5.203). Conclusion This nationwide study highlights an increased risk of severe COVID-19 in individuals with chronic HBV, particularly those with cirrhosis. Geographic and socioeconomic factors further influence outcomes. These findings underscore the need to consider HBV status in COVID-19 risk assessments. Future studies should explore these associations in the context of evolving SARS-CoV-2 variants and widespread vaccination.https://doi.org/10.1186/s12985-025-02743-5Viral hepatitisHBVHepatitis BCOVID-19SARS-CoV2 |
| spellingShingle | Frida Jakobsson Osvaldo Fonseca-Rodríguez Hanna Jerndal Sebastian Kalucza Soo Aleman Marie Eriksson Anne-Marie Fors Connolly Hepatitis B associated with severe COVID-19: a nationwide cohort study in Sweden Virology Journal Viral hepatitis HBV Hepatitis B COVID-19 SARS-CoV2 |
| title | Hepatitis B associated with severe COVID-19: a nationwide cohort study in Sweden |
| title_full | Hepatitis B associated with severe COVID-19: a nationwide cohort study in Sweden |
| title_fullStr | Hepatitis B associated with severe COVID-19: a nationwide cohort study in Sweden |
| title_full_unstemmed | Hepatitis B associated with severe COVID-19: a nationwide cohort study in Sweden |
| title_short | Hepatitis B associated with severe COVID-19: a nationwide cohort study in Sweden |
| title_sort | hepatitis b associated with severe covid 19 a nationwide cohort study in sweden |
| topic | Viral hepatitis HBV Hepatitis B COVID-19 SARS-CoV2 |
| url | https://doi.org/10.1186/s12985-025-02743-5 |
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