Impact of the COVID-19 pandemic on hospital admissions due to viral hepatitis in Spain

J Clin Virol. 2023 Oct:167:105553. doi: 10.1016/j.jcv.2023.105553. Epub 2023 Jul 27.


Background: Before the advent of COVID-19 vaccines, hospitalizations due to SARS-CoV-2 infection during 2020 collapsed most medical centers worldwide. Disruptions in health care for clinical conditions other than COVID-19 were not uniform. Herein, we report the impact of COVID-19 on hospitalizations due to viral hepatitis in Spain.

Methods: Retrospective study of all hospitalizations in Spain during 10 months before (pre-pandemic period) and after (pandemic period) March 1st 2020. Admissions with a diagnosis of hepatitis B, C and/or delta were retrieved and compared using the Spanish National Registry of Hospital Discharges.

Results: Nationwide hospitalizations declined 14.6% during the pandemic period, from 3,144,164 to 2,684,845. This reduction was significantly more pronounced for admissions due to viral hepatitis (18.1% drop), falling from 46,521 to 38,115. During the pandemic period, patients admitted with viral hepatitis died significantly more frequently than during the pre-pandemic period (7.2% vs 6.1%; p < 0.001). Liver transplants significantly declined during the pandemic period. COVID-19 was diagnosed in 10.3% of patients hospitalized with viral hepatitis during the pandemic period. This subset of patients was older and died 2.4-fold more frequently than the rest, despite having advanced liver disease less frequently.

Conclusion: Hospitalizations due to viral hepatitis significantly declined in Spain during the COVID-19 pandemic. Patients admitted with viral hepatitis experienced a greater mortality during the pandemic period. Deaths were more pronounced when coinfected with SARS-CoV-2 despite having advanced liver disease less frequently.

Keywords: COVID-19; Cirrhosis; Epidemiology; Hospitalizations; Liver disease; Viral hepatitis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19 Vaccines
  • COVID-19* / epidemiology
  • Hepatitis, Viral, Human*
  • Hospitalization
  • Humans
  • Pandemics / prevention & control
  • Retrospective Studies
  • SARS-CoV-2
  • Spain / epidemiology
  • Tertiary Care Centers


  • COVID-19 Vaccines