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Hepatitis B virus associated with severe acute respiratory syndrome coronavirus 2 infection: a case report.

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 101293382 Publication Model: Electronic Cited Medium: Internet ISSN: 1752-1947 (Electronic) Linking ISSN: 17521947 NLM ISO Abbreviation: J Med Case Rep Subsets: MEDLINE
    • Publication Information:
      Original Publication: [London] : BioMed Central, [2007-
    • Subject Terms:
      COVID-19*/complications ; COVID-19*/diagnosis ; Hepatitis B, Chronic*/complications; Humans ; Male ; Aged ; SARS-CoV-2 ; Antiviral Agents/therapeutic use
    • Abstract:
      Competing Interests: Declarations. Ethics approval and consent to participate: Approved by the ethics committee of the hospital for infectious diseases Saint Parascheva Iasi. Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Institutional review board: Not applicable. Consent for publication: Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Competing interests: The authors declare that they have no competing interests.
      Background: After secondary respiratory failure, liver failure is often reported in the literature on coronavirus disease 2019 infection. Angiotensin-converting enzyme 2 receptors in hepatocytes make the liver directly susceptible to the severe acute respiratory syndrome coronavirus 2 virus. An exacerbated immune response, drug-induced hepatotoxicity, and hypoxia secondary to respiratory failure are further possible causes of hepatocytolysis in coronavirus disease 2019 patients. Pre-existing infection with the hepatitis B virus can aggravate coronavirus disease 2019 or be aggravated/reactivated by it. This case report describes unusually severe liver damage in a coronavirus disease 2019 patient with well controlled hepatitis B, where the evidence points to coronavirus disease 2019-related factors as the main causes of hepatic cytolysis.
      Case Presentation: A 70 year-old patient of Romanian ethnicity with a 5-year history of chronic hepatitis B presented to the emergency department complaining of fever, chills, and marked physical asthenia with an onset of 2 weeks. Blood tests revealed an inflammatory syndrome and incipient liver cytolysis. Low-intensity opacities were visible on chest X-ray, and the severe acute respiratory syndrome coronavirus 2 polymerase chain reaction test was positive, so the patient was transferred to the infectious diseases hospital. His condition then aggravated atypically, with increasingly severe hepatic cytolysis that was not noted in other coronavirus disease 2019 patients with hepatitis B.
      Conclusion: The patient's history of well-controlled hepatitis B suggests that, in this case, liver dysfunction was secondary to coronavirus disease 2019 manifestations such as the cytokine storm, respiratory failure, and drug-induced hepatotoxicity. The patient eventually recovered, and there was no demonstrable reactivation of hepatitis B after discharge. Coronavirus disease 2019 can thus affect liver function severely and primarily, yet without necessarily interacting with adequately managed hepatitis B.
      (© 2025. The Author(s).)
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    • Contributed Indexing:
      Keywords: COVID-19; Case report; Hepatic cytolysis; Hepatitis B; SARS-CoV-2
    • Accession Number:
      0 (Antiviral Agents)
    • Publication Date:
      Date Created: 20250227 Date Completed: 20250228 Latest Revision: 20250510
    • Publication Date:
      20250511
    • Accession Number:
      PMC11869702
    • Accession Number:
      10.1186/s13256-025-05085-6
    • Accession Number:
      40016849