Effects of immunosuppressive drugs on COVID-19 severity in patients with autoimmune hepatitis.

Autor: Efe C; Department of Gastroenterology, Harran University Hospital, Şanlıurfa, Turkey., Lammert C; Department of Medicine Indiana, University School of Medicine Indianapolis, Indianapolis, Indiana, USA., Taşçılar K; Department of Medicine 3-Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany., Dhanasekaran R; Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University, Stanford, California, USA., Ebik B; Department of Gastroenterology, Gazi Yaşargil Education and Research Hospital, Diyarbakir, Turkey., Higuera-de la Tijera F; Gastroenterology and Hepatology Unit, Hospital General de México, Ciudad de México, México., Calışkan AR; Department of Gastroenterology, Adıyaman University, Adıyaman, Turkey., Peralta M; Hepatology Section, Hospital Francisco J Muñiz, Ciudad Autónoma de Buenos Aires, Argentina.; Latin American Liver Research Educational and Awareness Network (LALREAN), Pilar, Argentina., Gerussi A; Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), San Gerardo Hospital, Monza, Italy., Massoumi H; Department of Medicine, Montefiore Medical Center, Bronx, New York, USA., Catana AM; Division of Gastroenterology/Hepatology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA., Purnak T; Division of Gastroenterology, Hepatology and Nutrition, McGovern Medical School, Houston, Texas, USA., Rigamonti C; Department of Translational Medicine, Università del Piemonte Orientale UPO, Novara, Italy.; Division of Internal Medicine, 'AOU Maggiore della Carità', Novara, Italy., Aldana AJG; Gastroenterology and Hepatology Unit, Fundación Santa Fe de Bogotá y universidad de Los Andes, Bogotá, Colombia., Khakoo N; Division of Digestive Health and Liver Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA., Nazal L; Gastroenterology and Hepatology Unit, Clínica Las Condes, Santiago de Chile, Chile., Frager S; Department of Medicine, Montefiore Medical Center, Bronx, New York, USA., Demir N; Department of Gastroenterology, Haseki Training and Research Hospital, Istanbul, Turkey., Irak K; Department of Gastroenterology, SBU Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey., Melekoğlu-Ellik Z; Department of Gastroenterology, Ankara University Medical Faculty, Ankara, Turkey., Kacmaz H; Department of Gastroenterology, Adıyaman University, Adıyaman, Turkey., Balaban Y; Department of Gastroenterology, Faculty of Medicine, Hacettepe University, Ankara, Turkey., Atay K; Departmant of Gastroenterology, Mardin State Hospital, Mardin, Turkey., Eren F; Departmant of Gastroenterology, Ordu State Hospital, Ordu, Turkey., Alvares-da-Silva MR; Gastroenterology and Hepatology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.; Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil., Cristoferi L; Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), San Gerardo Hospital, Monza, Italy., Urzua Á; Gastroenterology and Hepatology Unit. Hospital Clínico, Universidad de Chile, Santiago de Chile, Chile., Eşkazan T; Department of Gastroenterology, Cerrahpaşa School of Medicine, İstanbul, Turkey., Magro B; Gastroenterology Hepatology and Transplantation, ASST Papa Giovanni XXIII-Bergamo, Bergamo, Italy., Snijders R; Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands.; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Nijmegen, The Netherlands., Barutçu S; Department of Gastroenterology, University of Gaziantep Medical Faculty, Gaziantep, Turkey., Lytvyak E; Division of Gastroenterology and Liver Unit, University of Alberta, Edmonton, Alberta, Canada., Zazueta GM; Gastroenterology Unit, Instituto Nacional de Ciencias Médicas y Nutrición 'Salvador Zubirán', Ciudad de México, México., Demirezer-Bolat A; Department of Gastroenterology, Ankara City Hospital, Ankara, Turkey., Aydın M; School of Medicine, Department of Gastroenterology, Van Yuzuncu Yil University, Van, Turkey., Heurgue-Berlot A; Department of Hepato-Gastroenterology, CHU Reims, Reims, France., De Martin E; Centre Hepato-Biliaire, Hôpital Paul-Brousse, FHU Hepatinov, INSERM Unit UMR 1193, Univ Paris-Saclay, Gif-sur-Yvette, France., Ekin N; Department of Gastroenterology, Gazi Yaşargil Education and Research Hospital, Diyarbakir, Turkey., Yıldırım S; Department of Gastroenterology, Erciyes Hospital, Kayseri, Turkey., Yavuz A; Division of Gastroenterology, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey., Bıyık M; Division of Gastroenterology, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey., Narro GC; Gastroenterology Unit, Instituto Nacional de Ciencias Médicas y Nutrición 'Salvador Zubirán', Ciudad de México, México., Kıyıcı M; Department of Gastroenterology, Medical Faculty, Uludag University, Bursa, Turkey., Akyıldız M; Department of Gastroenterology, Koc University School of Medicine, Istanbul, Turkey., Kahramanoğlu-Aksoy E; Department of Gastroenterology, Keçiören Training and Research Hospital, Ankara, Turkey., Vincent M; Department of Internal Medicine, Donald and Barbara Zucker School of Medicine, Northwell Health, Manhasset, NY, USA., Carr RM; Division of Gastroenterology, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Günşar F; Department of Gastroenterology, Ege University School of Medicine, İzmir, Turkey., Reyes EC; Hepatology Unit. Hospital Militar Central de México, Ciudad de México, México., Harputluoğlu M; Department of Gastroenterology, Inönü University School of Medicine, Malatya, Turkey., Aloman C; Section of Hepatology, Rush University Medical Center, Chicago, Illinois, USA., Gatselis NK; Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa, Larissa, Greece., Üstündağ Y; Department of Gastroenterology, Bulent Ecevit University of Medicine, Zonguldak, Turkey., Brahm J; Gastroenterology Unit, Clínica Las Condes, Santiago, Chile., Vargas NCE; Hepatology Unit Hospital Nacional Almanzor Aguinaga Asenjo, Chiclayo, Perú., Güzelbulut F; Department of Gastroenterology, Haydarpaşa Numune Education and Research Hospital, İstanbul, Turkey., Garcia SR; Gastroenterology Unit, Hospital Víctor Lazarte Echegaray, Trujillo, Perú., Aguirre J; Hepatology Unit, Hospital Ángeles Pedregal, Ciudad de México, México., Anders M; Hepatology and Liver Transplant Unit, Hospital Alemán, Buenos Aires, Argentina., Ratusnu N; Hepatology Unit, Hospital Regional de Ushuaia, Ushuaia, Argentina., Hatemi I; Department of Gastroenterology, Cerrahpaşa School of Medicine, İstanbul, Turkey., Mendizabal M; Latin American Liver Research Educational and Awareness Network (LALREAN), Pilar, Argentina.; Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina., Floreani A; Scientific Consultant IRCCS Negrar, Verona, Italy.; Senior Scholar, University of Padova, Padova, Italy., Fagiuoli S; Gastroenterology Hepatology and Transplantation, ASST Papa Giovanni XXIII-Bergamo, Bergamo, Italy., Silva M; Latin American Liver Research Educational and Awareness Network (LALREAN), Pilar, Argentina.; Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina., Idilman R; Department of Gastroenterology, Ankara University Medical Faculty, Ankara, Turkey., Satapathy SK; Department of Internal Medicine, Donald and Barbara Zucker School of Medicine, Northwell Health, Manhasset, NY, USA., Silveira M; Department of Medicine, Section of Digestive Diseases Yale School of Medicine, New Haven, Connecticut, USA., Drenth JPH; Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands.; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Nijmegen, The Netherlands., Dalekos GN; Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa, Larissa, Greece., N Assis D; Department of Medicine, Section of Digestive Diseases Yale School of Medicine, New Haven, Connecticut, USA., Björnsson E; Department of Internal Medicine, Section of Gastroenterology, Landspitali University Hospital, Reykjavik, Iceland., Boyer JL; Department of Medicine, Section of Digestive Diseases Yale School of Medicine, New Haven, Connecticut, USA., Yoshida EM; Division of Gastroenterology, University of British Columbia and Vancouver General Hospital, Vancouver, Canada., Invernizzi P; Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), San Gerardo Hospital, Monza, Italy., Levy C; Division of Digestive Health and Liver Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA., Montano-Loza AJ; Division of Gastroenterology and Liver Unit, University of Alberta, Edmonton, Alberta, Canada., Schiano TD; Division of Liver Diseases, The Mount Sinai Medical Center, New York, New York, USA., Ridruejo E; Latin American Liver Research Educational and Awareness Network (LALREAN), Pilar, Argentina.; Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina.; Hepatology Section, Department of Medicine, Centro de Educación Médica e Investigaciones Clínicas, CEMIC, Ciudad Autónoma de Buenos Aires, Argentina., Wahlin S; Hepatology Division, Department of Upper GI Diseases, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
Jazyk: angličtina
Zdroj: Liver international : official journal of the International Association for the Study of the Liver [Liver Int] 2022 Mar; Vol. 42 (3), pp. 607-614. Date of Electronic Publication: 2021 Dec 13.
DOI: 10.1111/liv.15121
Abstrakt: Background: We investigated associations between baseline use of immunosuppressive drugs and severity of Coronavirus Disease 2019 (COVID-19) in autoimmune hepatitis (AIH).
Patients and Methods: Data of AIH patients with laboratory confirmed COVID-19 were retrospectively collected from 15 countries. The outcomes of AIH patients who were on immunosuppression at the time of COVID-19 were compared to patients who were not on AIH medication. The clinical courses of COVID-19 were classified as (i)-no hospitalization, (ii)-hospitalization without oxygen supplementation, (iii)-hospitalization with oxygen supplementation by nasal cannula or mask, (iv)-intensive care unit (ICU) admission with non-invasive mechanical ventilation, (v)-ICU admission with invasive mechanical ventilation or (vi)-death and analysed using ordinal logistic regression.
Results: We included 254 AIH patients (79.5%, female) with a median age of 50 (range, 17-85) years. At the onset of COVID-19, 234 patients (92.1%) were on treatment with glucocorticoids (n = 156), thiopurines (n = 151), mycophenolate mofetil (n = 22) or tacrolimus (n = 16), alone or in combinations. Overall, 94 (37%) patients were hospitalized and 18 (7.1%) patients died. Use of systemic glucocorticoids (adjusted odds ratio [aOR] 4.73, 95% CI 1.12-25.89) and thiopurines (aOR 4.78, 95% CI 1.33-23.50) for AIH was associated with worse COVID-19 severity, after adjusting for age-sex, comorbidities and presence of cirrhosis. Baseline treatment with mycophenolate mofetil (aOR 3.56, 95% CI 0.76-20.56) and tacrolimus (aOR 4.09, 95% CI 0.69-27.00) were also associated with more severe COVID-19 courses in a smaller subset of treated patients.
Conclusion: Baseline treatment with systemic glucocorticoids or thiopurines prior to the onset of COVID-19 was significantly associated with COVID-19 severity in patients with AIH.
(© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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