COVID-19 infection and health outcomes in people living with hepatitis B and C in England

🧪 What was the study about?

This study explored how COVID-19 affected people in England who had previously been diagnosed with hepatitis B or hepatitis C. It looked at how often these individuals became infected with COVID-19, how many became seriously ill or required hospital care, and how many died following infection. The study also examined whether certain factors, such as age, sex, ethnicity, deprivation, and vaccination status, influenced the risk of severe COVID-19 outcomes.

❓ Why is this important?

People living with hepatitis B or C may have underlying liver damage or other health and social vulnerabilities that could increase their risk of severe COVID-19. Understanding how COVID-19 impacts these groups is important for identifying those at higher risk, improving healthcare planning, and ensuring that the most vulnerable populations are prioritised for prevention measures such as vaccination. It also helps guide responses to future pandemics by highlighting how pre-existing conditions affect outcomes.

🔍 What did we do?

We used national surveillance data from England to identify people diagnosed with hepatitis B and hepatitis C. These records were linked to COVID-19 testing data, hospital admission data, death records, and vaccination data. We analysed how many people in these groups tested positive for COVID-19, were hospitalised, or died, and compared health outcomes across different demographic and clinical characteristics. We also carried out a more detailed analysis in people with hepatitis C to investigate whether the severity of liver disease affected their COVID-19 outcomes.

📊 Key findings

COVID-19 infection rates were moderate in both groups, but health outcomes varied. Older age and being unvaccinated were the strongest risk factors for both death and hospitalisation. In people with hepatitis B, males were also at higher risk of death. In those with hepatitis C, living in more deprived areas was linked to a higher risk of dying from COVID-19. Vaccination significantly reduced the risk of death and hospitalisation in both groups. In the hepatitis C subgroup, individuals with advanced liver disease (cirrhosis) had a much higher risk of dying from COVID-19 compared to those without liver damage, although liver disease stage was not clearly linked to hospitalisation risk.

💡 What do these findings mean?

These results show that while hepatitis B and C themselves may not be the main drivers of COVID-19 risk, factors such as age, vaccination status, deprivation, and liver disease severity play a major role. Ensuring high vaccination coverage and targeted support for older individuals and those with advanced liver disease is crucial. The findings also highlight the importance of addressing health inequalities, as people living in more deprived areas were at greater risk of poor health outcomes. Overall, this study provides useful evidence to help guide public health policies and protect vulnerable groups during future infectious disease outbreaks.