肝脂肪变性对慢性乙型肝炎和 SARS-CoV-2 感染者急性肝损伤风险的影响

Matthew S. H. Chung, Carlos K. H. Wong, Xue Li, Francisco T. T. Lai, Eric Y. F. Wan, Celine S. L. Chui, Franco W. T. Cheng, Esther W. Chan, Ching Lung Cheung, Xi Xiong, Lanlan Li, Wai Kay Seto, Man-Fung Yuen, Lung-Yi Mak, Ian C. K. Wong
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引用次数: 0

摘要

背景 据了解,SARS-CoV-2 感染与慢性乙型肝炎(CHB)患者肝功能损害的风险较高有关。然而,目前还没有证据表明同时患有肝脂肪变性(HS)的慢性乙型肝炎和 SARS-CoV-2 感染者患肝病的风险会受到影响。我们研究了合并 HS 对感染 SARS-CoV-2 的 CHB 患者的影响。 方法 使用电子健康数据库对 2020 年 1 月 21 日至 2023 年 1 月 31 日期间确诊感染 SARS-CoV-2 的香港慢性阻塞性肺病患者进行回顾性队列研究。研究人员确定了确诊为非典型肺炎(非典型肺炎+CHB+COVID-19)的患者,并通过倾向得分与未确诊为非典型肺炎(CHB+COVID-19)的患者进行了1:1配对。对每个人进行随访,直至死亡、出现结果事件或 2023 年 1 月 31 日。研究结果是 COVID-19 诊断后 28 天内急性肝损伤 (ALI) 的发生率。研究还分析了ALI的严重程度,以及根据是否存在CHB感染和HS对ALI风险进行的分层比较。通过泊松回归模型估算了发病率比(IRR)。 结果 在队列中的52 259名COVID-19合并CHB感染的患者中,有15 391人合并HS + CHB + COVID-19,15 391人合并CHB + COVID-19。与 CHB + COVID-19 相比,HS + CHB + COVID-19 与 ALI 风险增加有关(IRR:1.41,95% CI:1.05-1.90,p = 0.023)。超过99%的ALI病例为轻度至中度,HS + CHB + COVID-19与CHB + COVID-19之间的ALI严重程度没有差异(p = 0.127)。 结论 在感染了SARS-CoV-2的CHB感染者中,合并HS与ALI风险增加有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Impact of hepatic steatosis on risk of acute liver injury in people with chronic hepatitis B and SARS-CoV-2 infection

Impact of hepatic steatosis on risk of acute liver injury in people with chronic hepatitis B and SARS-CoV-2 infection

Background

SARS-CoV-2 infection was known to be associated with higher risk of liver impairment in people with chronic hepatitis B infection (CHB). However, evidence regarding the impact of concomitant hepatic steatosis (HS) on the risk of liver disease among people with CHB and SARS-CoV-2 infection is lacking. We investigated the impact of concomitant HS on people with CHB suffering from SARS-CoV-2 infection.

Methods

This retrospective cohort study was performed using an electronic health database for people in Hong Kong with CHB and confirmed SARS-CoV-2 infection between 21 January 2020 and 31 January 2023. People with HS diagnosis (HS + CHB + COVID-19) were identified and matched 1:1 by propensity score with those without (CHB + COVID-19). Each person was followed up until death, outcome event, or 31st January 2023. Study outcome was incidence of acute liver injury (ALI) within first 28 days since COVID-19 diagnosis. Severity of ALI and comparison of ALI risk stratified by the presence of CHB infection and HS were also analysed. Incidence rate ratios (IRRs) were estimated by Poisson regression models.

Results

Of 52 259 COVID-19 patients with CHB infection in the cohort, 15 391 people with HS + CHB + COVID-19 and 15 391 people with CHB + COVID-19 were included after matching. HS + CHB + COVID-19 was associated with increased risk of ALI (IRR: 1.41, 95% CI:1.05–1.90, p = 0.023), compared to CHB + COVID-19. Over 99% ALI cases were mild to moderate severity, and there were no differences in the severity of ALI between HS + CHB + COVID-19 and CHB + COVID-19 (p = 0.127).

Conclusions

Concomitant HS was associated with increased risk of ALI among people with CHB infection suffering from SARS-CoV-2 infection.

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