SARS-CoV-2 infection in patients with autoimmune hepatitis
| العنوان: | SARS-CoV-2 infection in patients with autoimmune hepatitis |
|---|---|
| المؤلفون: | Thomas Marjot, Gustav Buescher, Marcial Sebode, Eleanor Barnes, A. Sidney Barritt, Matthew J. Armstrong, Luke Baldelli, James Kennedy, Carolyn Mercer, Ann-Kathrin Ozga, Christian Casar, Christoph Schramm, Andrew M. Moon, Gwilym J. Webb, Ansgar W. Lohse |
| المصدر: | Journal of Hepatology |
| بيانات النشر: | BMJ Publishing Group, 2023. |
| سنة النشر: | 2023 |
| مصطلحات موضوعية: | 0301 basic medicine, medicine.medical_specialty, Cirrhosis, medicine.medical_treatment, Autoimmune hepatitis, Antibodies, Viral, Chronic liver disease, Gastroenterology, Article, Immunocompromised Host, 03 medical and health sciences, Liver disease, 0302 clinical medicine, immune system diseases, Internal medicine, medicine, Humans, immunosuppression, autoimmune hepatitis, Hepatology, SARS-CoV-2, business.industry, COVID-19, Immunosuppression, medicine.disease, digestive system diseases, Hepatitis, Autoimmune, 030104 developmental biology, Immunosuppressive drug, Cohort, Etiology, 030211 gastroenterology & hepatology, business |
| الوصف: | Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 2019 (COVID-19) continues to have a devastating impact across the globe. However, little is known about the disease course in patients with autoimmune hepatitis (AIH). Methods Data for patients with AIH and SARS-CoV-2 infection were combined from three international reporting registries and outcomes were compared to those with chronic liver disease of other aetiology (non-AIH CLD) and to patients without liver disease (non-CLD). Results Between 25th March and 24th October 2020, data were collected for 932 patients with CLD and SARS-CoV-2 infection including 70 with autoimmune hepatitis (AIH). Fifty-eight (83%) of AIH patients were taking one or more immunosuppressive drug. There were no differences in rates of major outcomes between AIH and non-AIH CLD including hospitalization (76% vs 85%; p= 0.06), ICU admission (29% vs. 23%; p=0.240), and death (23% vs. 20%; p=0.643). Factors associated with death within the AIH cohort included age (OR 2.16/10 years; 1.07–3.81), Child-Turcotte-Pugh (CTP) class B (OR 42.48; 4.40–409.53), and CTP-C cirrhosis (OR 69.30; 2.83–1694.50), but not use of immunosuppression. Propensity score matched (PSM) analysis comparing AIH with non-AIH CLD demonstrated no increased risk adverse outcomes including death (+3.2%; -9.2%–15.7%). PSM analysis of AIH versus non-CLD patients (n=769) demonstrated increased risk of hospitalization with AIH (+18.4%; 5.6–31.2%), but equivalent risk of all other outcomes including death (+3.2%; -9.1%–15.6%). Conclusion AIH patients were not at increased risk of adverse outcomes despite immunosuppressive treatment compared to other causes of CLD and to matched cases without liver disease. Graphical abstract Highlights • This is the largest cohort of patients with autoimmune hepatitis and laboratory proven SARS-COV-2 infection reported to date. • There were no differences in rates of major adverse COVID-19 outcomes including hospitalization, intensive care unit (ICU) admission, and death between AIH patients and those with other aetiologies of liver disease. • When compared to patients without liver disease in propensity score matched analysis, patients with AIH had higher rates of hospitalization but no increased risk of ICU admission or death despite potential reporting of AIH cases with more severe baseline liver disease. • Independent risk factors for death in AIH patients were age and baseline liver disease severity, but not the use of immunosuppression. Lay summary: Little is known about the outcomes of COVID-19 in patients with autoimmune hepatitis (AIH), a rare chronic inflammatory liver disease. This study combines data from three large registries to describe the course of COVID-19 in this patient group. We show that AIH patients do not appear to have an increased risk of death from COVID-19 compared to patients with other forms of liver disease and compared to patients without liver disease, despite the use of medications which suppress the immune system. |
| اللغة: | English |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f04036cd23869f0ed89fc0c14e2efddfTest https://doi.org/10.1136/gutjnl-2021-bsg.13Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....f04036cd23869f0ed89fc0c14e2efddf |
| قاعدة البيانات: | OpenAIRE |
| الوصف غير متاح. |