P- 76 elevated fibrosis level in patients coinfected with hepatitis and covid-19 during a longitudinal study

Introduction and Objectives: Altered biochemical and hematological markers have been associated with the aggravation of covid-19. There is limited information on the evaluation of the degree of liver injury, especially fibrosis, in infected patients who already have a history of liver injury. This study aimed to evaluate the level of fibrosis in patients coinfected with hepatitis and covid-19 during a one-year follow-up. Materials and Methods: This is a longitudinal observational study. Two hundred and thirty individuals were recruited for a period of 12 months during the years 2020 to 2021. Blood was collected for hematological and biochemical tests for fibrosis calculation by using APRI index. Nasal and oropharyngeal swab samples were submitted to RT-qPCR test for detection of SARS-CoV-2 RNA. Results: Mean age of the population was 48 years (± 17.09; 11-90) and half of them were women (115/230). Among the study participants, 40% (90/230) had hepatitis, and of this group, 14% (13/90) had covid-19. Compared to the group without hepatitis (140), 27% (39/140) had only covid-19 and high fibrosis grade (FIB-4) presented as a risk factor for this group. Notably, during the longitudinal study, it was noticed that there was an elevation in the degree of fibrosis among the coinfected patients when compared to the other groups. At the beginning of follow-up and during the acute phase of SARS-CoV-2 infection, coinfected patients presented a low grade of fibrosis (F0); after one year, and in a post-COVID setting, a high grade of fibrosis (F4) was observed in this group. The increase in fibrosis grade was not observed among monoinfected COVID-19 or hepatitis groups. Conclusions: We observed an increased level of fibrosis among COVID-19 patients with liver disease as a post-covid condition in this group, which may represent an impact of SARS-CoV-2 infection in patients with a history of liver injury.