Viral Hepatitis and COVID-19: A Systematic Review on the Current Evidences

Milad Jalilian


Background: COVID-19 pneumonia is a newly recognized illness that is spreading rapidly around the world and causes many disability and deaths. Some diseases, for instance viral hepatitis, is continuously suggested as a risk factor which contributes to the severity and mortality of COVID-19. However, to date, there are no comprehensive studies aiming to explain the exact relationship between viral hepatitis and COVID-19. Thus, this study aims to summarize the evidence about viral hepatitis and COVID-19 outbreak through a systematic review approach.

Methods: A literature review was implemented within databases of Scopus, PubMed, Elsevier, Science Direct, Cochrane Library, Google Scholar, and Web of science. Observational reviews, case-report, and case-series studies that assessed the hepatitis in COVID-19 patients, were included. Data extraction and assessment were guided by PRISMA checklist.

Results: Some studies showed that there were liver symptoms such as increasing in liver enzyme and functions. The prevalence of hepatitis B was between 0.7% to 6.4% and the prevalence of hepatitis C was 1.9%. These patients have prolonged hospitalization, poor prognosis, severe symptoms, and the death rate is higher among COVID-19 patients. In addition, it is suggested the hepatitis patients will be treated with antivirals especially lopinavir/ritonavir that was useful for treatment of SARS-CoV1 patients.

Conclusions: The results showed hepatitis should be considered as a risk factor for the severity of symptoms of COVID-19. And the adverse effect of COVID-19 in hepatitis patients are more than others. So, the use of antiviral medications can prevent the reactivation of hepatitis and reduce the severity of COVID-19.

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