Can COVID-19 Cause Flare-Ups of Acute Hepatitis B? An Atypical Presentation of COVID-19 with Acute Hepatitis B

Table 1

Clinical laboratory results on days 0, 3, and 6 of treatment.

Item	Day 0	Day 3	Day 6	Reference range
Body temperature (°C)	39.4	36	39.9	36.1–37.0
Pulse (beats/min)	134	85	96	60–100
Respiratory rate (breaths/min)	27	MV	MV	12–20
Blood pressure (mmHg)	126/84	136/85	150/93	90–140/60–90
Hemoglobin (g/dL)	13.9	9.1	9.8	13–17
White blood cell (×10^3/μL)	10	8.1	10.1	04–10
Neutrophil (%)	78	56.5	60	50–75
Absolute neutrophil (×10^3/μL)	8	4.6	6.1	2.0–7.5
Lymphocyte (%)	14	26.3	16	20–40
Absolute lymphocyte (×10^3/μL)	1.4	2.1	1.6	0.8–4.0
Platelets (×10^3/μL)	64	32	39	150–400
C-reactive protein (mg/L)	67.4	11.8	<5	0–10
Procalcitonin (ng/mL)	0.8	0.81	0.71	0–0.5
Lactate (mmol/L)	22.8	7	6.7	0.36–1.6
pH value	7.14	7.5	7.53	7.350–7.450
Oxygen saturation (%)	98	100	100	94–100
Bicarbonate (mmol/L)	7.4	25	25	22–29
Alanine aminotransferase (U/L)	>7000	1089	188	0–40
Aspartate aminotransferase (U/L)	>7000	526	98	0–41
Total bilirubin (μmol/L)	115	134	210	0–21
Direct bilirubin (μmol/L)	66	49.4	65.5	0–5
Alkaline phosphatase (U/L)	174	139	132	40–129
Creatinine (μmol/L)	305	635	568	62–106
Glucose (mmol/L)	3.2	8.5	13.7	3.9–6.1
Ammonia (μmol/L)	268	265	162	16–60
D-Dimer (mg/L)	11.5	8.7	33.18	0–0.5
Fibrinogen (g/L)	1.75	1.5	0.4	2–4.1
INR	>10	7	2.2	<1.1
PT (seconds)	>120	84.1	26.6	9.4–12.5
APTT (seconds)	64	44.9	40.3	25.1–36.5
Ferritin (μg/L)	20573	2984	1447	38–270
Ethanol	Negative
Salicylate	Negative
Blood culture and sensitivity	Negative		Negative
Hepatitis B core Ab	Reactive
Hepatitis B core Ab IgM	Reactive
Hepatitis B surface antigen	Reactive
Hepatitis B surface Ab	Nonreactive
Hepatitis B surface Ab Num.	<2.00
Hepatitis Be antigen	Reactive
Hepatitis Be Ab	Nonreactive
Hepatitis C Ab	Nonreactive
Hepatitis B D Ab	Nonreactive
Hepatitis total A Ab	Reactive