To look at the effect of tenofovir on COVID-19 outcomes, Spanish
researchers identified all people with chronic hepatitis B receiving treatment
with tenofovir or entecavir at 28 Spanish hospitals who were diagnosed with COVID-19
between 1 February 2020 and 30 November 2020. The study looked at the
relationship between hepatitis B treatment and COVID-19 mortality, severe
COVID-19, need for ventilation or intensive care unit admission.
The analysis identified 4736 people with chronic hepatitis
B receiving antiviral treatment; of these, 117 had been diagnosed with
COVID-19. Sixty-seven were taking tenofovir and 50 were taking entecavir.
People taking entecavir were older, more likely to have hypertension, type 2
diabetes or to be obese, and showed a trend towards more advanced fibrosis.
Although the incidence of COVID-19 was similar in the two
treatment groups, people taking entecavir were significantly more likely to
develop severe COVID-19 (including acute respiratory distress, double pneumonia
or sepsis) (36% vs 6%, p<0.01), require intensive care unit admission (10% vs 0%, p=0.01), require
ventilation support (20% vs 3%, p<0.01) and spend longer in hospital (10 vs
3 days, p<0.01). However, there was no significant difference in the death
rate (10% vs 1.5%, p=0.08).
Multivariate logistic regression adjusted by age, sex,
obesity, co-morbidities and fibrosis stage showed that tenofovir treatment
reduced the risk of severe COVID-19 sixfold (adjusted odds ration 0.17, 95% CI