Benign course of hepatitis A and COVID-19 coinfection - A retrospective observational case series with comparative analysis

Q: What was the study objective regarding HAV and COVID-19 coinfection?

To evaluate whether COVID-19 coinfection worsens clinical outcomes or liver injury in patients with HAV infection.

Q: How were participants grouped and what outcomes were compared?

Fifteen confirmed HAV patients were included: 7 with HAV–COVID-19 coinfection and 8 with HAV alone. Clinical characteristics, liver function tests, inflammatory markers, and recovery trends were compared at Day 1 and Day 10, with follow-up extended to 30 days.

Q: What did the study find about liver injury and recovery between groups?

All patients experienced mild disease without hepatic complications or ICU admissions. CRP was significantly higher in the coinfection group at both time points, but no statistically significant differences were seen in liver enzymes or recovery rates compared with HAV alone.

Sep 28, 2026

Uploaded by Cipher

Evaluate whether COVID-19 coinfection worsens clinical outcomes or liver injury in patients with hepatitis A virus (HAV). A retrospective observational study in Lebanon enrolled 15 confirmed HAV patients: 7 with HAV–COVID-19 coinfection and 8 with HAV alone. Liver function tests, inflammatory markers, and recovery trends were assessed at Day 1 and Day 10, with remote follow-up to 30 days. All patients showed mild courses; CRP was higher with coinfection, without significant liver enzyme differences or delayed recovery, though coinfection screening remains advisable.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages6

Reading Time15 min

AccessFree to download

Introduction

Methods

Results

Conclusion

IDCases 43 (2026) e02453 Contents lists available at ScienceDirect IDCases journal [homepage:](homepage: www.elsevier.com/locate/idcases)[ www.elsevier.com/locate/idcases](homepage: www.elsevier.com/locate/idcases) | Benign course of hepatitis A and COVID-19 coinfection: A retrospective observational case series with comparative analysis
Georges Khalil a,b,*,1 , Alexia Khoury c,2, Marina Antoinette Khalild, Noura Abbase, Mitchelle Issac, Youssef El Toumc, Giovanni Yannif
a Medical Microbiology Department, Faculty of Medicine, Saint Joseph University, Beirut Lebanon, Campus des sciences m´edicales, Rue de Damas, B.P. 11-5076-Riad El Solh, Beyrouth 1107 2180, Lebanon
b Hˆopital Universitaire Saint Joseph des Sœurs de la Croix-Centre M´edical Raymond et Aida Najjar, P.O. Box 90-375 Bauchrieh, Dora-Metn, Beirut, Lebanon c Faculty of Medicine, Saint Joseph University, Beirut Lebanon, B.P. 11-5076-Riad El Solh, Beyrouth 1107 2180, Lebanon
d School of Art and Sciences, Lebanese American University (LAU), POBox 36, Byblos, Lebanon
e Department of Internal Medicine, American University of Beirut Medical Center, PO Box: 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon f Faculty of Medicine, Lebanese University, Beirut, Lebanon | | | | --- | --- | --- | | A R T I C L E I N F O | | A B S T R A C T | | Keywords: Hepatitis ACOVID-19
Liver injury
Co-infection Inflammatory markers Endemic disease | | Background: In regions where hepatitis A virus (HAV) is endemic, the COVID-19 pandemic has introduced new challenges. While liver involvement in SARS-CoV-2 is well documented, the impact of HAV–COVID-19 coinfection remains unclear.
Objective: Evaluate whether COVID-19 coinfection worsens clinical outcomes or liver injury in patients with HAV infection.
Methods: We conducted a retrospective observational study at a tertiary care hospital in Lebanon, including 15 patients with confirmed HAV infection: 7 individuals were infected with COVID-19 (HAV–COVID coinfection group) and 8 with HAV alone (HAV-only group). Clinical characteristics, liver function tests, inflammatory markers, and recovery trends were assessed at admission (Day 1) and follow-up (Day 10) and remote follow-up extended up to 30 days. Group comparisons were made using Mann–Whitney U tests with effect sizes reported as rank-biserial correlations.
Results: All patients experienced a mild disease course without hepatic complications or ICU admissions. CRP levels were significantly higher in the HAV–COVID group at both time points (Day 1 p = 0.04; Day 10 p < 0.001), but no statistically significant differences were seen in liver enzymes or recovery rates between the groups. Conclusion: HAV–COVID-19 coinfection in otherwise healthy individuals does not appear to worsen liver injury or delay recovery compared to HAV alone. However, given isolated reports of fulminant hepatitis, clinicians should continue to screen for coinfection in patients presenting with liver injury during with COVID-19, especially in HAV-endemic regions. Larger studies are needed to confirm these findings and explore potential risk modifiers. | Introduction Hepatitis A virus (HAV) is the leading cause of acute viral hepatitis globally [1], particularly in low- and middle-income countries where sanitation infrastructure still remains suboptimal [2]. Lebanon, like many countries in the Eastern Mediterranean region, remains endemic for HAV, with periodic community-level outbreaks still occurring despite gradual improvements in hygiene and vaccination uptake [3]. At the same time, the COVID-19 pandemic has introduced new complexities to the management of infectious diseases, and led to a multifaceted interaction specially with hepatotropic viruses [4]. COVID-19 has been associated with hepatic dysfunction, either through * Correspondence to: Rue de Damas, B.P. 11-5076 - Riad El Solh, Beyrouth 1107 2180, Lebanon. E-mail addresses: [georges.khalil@usj.edu.lb](georges.khal

FAQs

What was the study objective regarding HAV and COVID-19 coinfection?

To evaluate whether COVID-19 coinfection worsens clinical outcomes or liver injury in patients with HAV infection.

How were participants grouped and what outcomes were compared?

Fifteen confirmed HAV patients were included: 7 with HAV–COVID-19 coinfection and 8 with HAV alone. Clinical characteristics, liver function tests, inflammatory markers, and recovery trends were compared at Day 1 and Day 10, with follow-up extended to 30 days.

What did the study find about liver injury and recovery between groups?

All patients experienced mild disease without hepatic complications or ICU admissions. CRP was significantly higher in the coinfection group at both time points, but no statistically significant differences were seen in liver enzymes or recovery rates compared with HAV alone.

Sep 28, 2026

Uploaded by Cipher