Presumed Protective Role for Anti-Hepatitis B Virus Antibodies Against COVID-19 Severe Cases: A Clinical Study Confirming in silico Hypothesis

Mariem Gdoura; Raoua Touati; Sana Kalthoum; Rania Ben Slama; Nouel Fatnassi; Mehdi Mrad; Lamia Ammari; Nozha Brahmi; Amira Ben Jazia; Nahed Hogga; Henda Triki; Sondes Haddad-Boubaker

doi:10.3389/fmed.2022.909660

Presumed Protective Role for Anti-Hepatitis B Virus Antibodies Against COVID-19 Severe Cases: A Clinical Study Confirming in silico Hypothesis

Front Med (Lausanne). 2022 Jul 8:9:909660. doi: 10.3389/fmed.2022.909660. eCollection 2022.

Authors

Mariem Gdoura^{1

2

3}, Raoua Touati^{1

2}, Sana Kalthoum⁴, Rania Ben Slama^{1

2}, Nouel Fatnassi^{2

4}, Mehdi Mrad⁵, Lamia Ammari^{2

6}, Nozha Brahmi⁷, Amira Ben Jazia⁷, Nahed Hogga^{1

2}, Henda Triki^{1

2}, Sondes Haddad-Boubaker^{1

2}

Affiliations

¹ Laboratory of Clinical Virology, WHO Regional Reference Laboratory for Poliomyelitis and Measles for the EMR, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia.
² LR20IPT10 Laboratory of Virus, Host and Vectors, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia.
³ Department of Clinical Biology, Faculty of Pharmacy of Monastir, University of Monastir, Monastir, Tunisia.
⁴ Centre National de Veille Zoosanitaire, Tunis, Tunisia.
⁵ Laboratory of Biochemistry, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia.
⁶ Infectious Diseases Departement, Rabta Hospital, Tunis, Tunisia.
⁷ Intensive Care Service, Emergence Medical Assistance Center, Tunis, Tunisia.

Abstract

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for COVID-19 disease which is known to have a broad clinical spectrum, from asymptomatic to critical presentation leading to death. Many researchers have investigated the factors impacting the course of the disease. Our previous in silico study suggested a possible protective effect of Hepatitis B, Tetanus and Measles vaccines against COVID-19. In continuity, we conducted a cross-sectional clinical study in order to confirm our in silico assumptions regarding the HBs-Ag antibodies.

Methods: A representative sex- and age-matched sample of patients with confirmed COVID-19 was selected (n = 340). All clinical presentations were equally represented. Using an ELISA test, each patient benefited of a serology for the detection and measurement of the anti-HBs specific IgG antibodies. The obtained results allowed determining the different correlations between these antibody titers and the disease severity. The R^® software and the MedCalc^® software served to calculate the Spearman's coefficient of rank correlation (rho) for the obtained titers per severity group as well as the different other calculations and figure representations.

Results: A significant positive correlation was found with the anti-HBs titers (rho = 0.107; p = 0.04). High anti-HBs titers were significantly associated with the mild presentation of COVID-19. A significant difference was found between the obtained titers per severity class (chi-2 test, p = 0.03).

Discussion/conclusion: Our findings demonstrated that anti-HBs titers were significantly higher for patients having mild COVID-19 presentations. We presume that being immunized against the HB may play a protective role in the course of the disease. Our study provided more key elements in understanding the disparity of the clinical spectrum among regions.

Keywords: COVID-19; Hepatitis B; SARS-CoV-2; antibody titer; correlation.