In this nationwide, population-based cohort of COVID-19 patients, we found an increased risk of severe COVID-19 (hospitalization, ICU treatment or death) in individuals with chronic HBV infection, even after adjusting for potential confounders. In addition to an increased risk in individuals who were male, elderly, non-vaccinated, and with low- socioeconomic status (SES), the multivariable models also showed that individuals diagnosed with HBV and born in Africa had a higher risk of severe COVID-19, including an increased risk of death due to COVID-19, compared to individuals with HBV infection born in other regions.
A potential mechanism, that could explain that persons with chronic hepatitis B with- or without cirrhosis have higher risk for severe COVID-19, is T-cell exhaustion. Chronic HBV leads to persistent…