Background and Aims: Data regarding outcome of COVID-19 in patients with autoimmune hepatitis (AIH) are lacking. Approach and Results: We performed a retrospective study on patients with AIH and COVID-19 from 34 centers in Europe and the Americas. We analyzed factors associated with severe COVID-19 outcomes, defined as the need for mechanical ventilation, intensive care admission, and/or death. The outcomes of patients with AIH were compared to a propensity score–matched cohort of patients without AIH but with chronic liver diseases (CLD) and COVID-19. The frequency and clinical significance of new-onset liver injury (alanine aminotransferase > 2 × the upper limit of normal) during COVID-19 was also evaluated. We included 110 patients with AIH (80% female) with a median age of 49 (range, 18-85) years at COVID-19 diagnosis. New-onset liver injury was observed in 37.1% (33/89) of the patients. Use of antivirals was associated with liver injury (P = 0.041; OR, 3.36; 95% CI, 1.05-10.78), while continued immunosuppression during COVID-19 was associated with a lower rate of liver injury (P = 0.009; OR, 0.26; 95% CI, 0.09-0.71). The rates of severe COVID-19 (15.5% versus 20.2%, P = 0.231) and all-cause mortality (10% versus 11.5%, P = 0.852) were not different between AIH and non-AIH CLD. Cirrhosis was an independent predictor of severe COVID-19 in patients with AIH (P < 0.001; OR, 17.46; 95% CI, 4.22-72.13). Continuation of immunosuppression or presence of liver injury during COVID-19 was not associated with severe COVID-19. Conclusions: This international, multicenter study reveals that patients with AIH were not at risk for worse outcomes with COVID-19 than other causes of CLD. Cirrhosis was the strongest predictor for severe COVID-19 in patients with AIH. Maintenance of immunosuppression during COVID-19 was not associated with increased risk for severe COVID-19 but did lower the risk for new-onset liver injury during COVID-19.
Efe, C., Dhanasekaran, R., Lammert, C., Ebik, B., Higuera-de la Tijera, F., Aloman, C., et al. (2021). Outcome of COVID-19 in Patients With Autoimmune Hepatitis: An International Multicenter Study. HEPATOLOGY, 73(6 (June 2021)), 2099-2109 [10.1002/hep.31797].
|Citazione:||Efe, C., Dhanasekaran, R., Lammert, C., Ebik, B., Higuera-de la Tijera, F., Aloman, C., et al. (2021). Outcome of COVID-19 in Patients With Autoimmune Hepatitis: An International Multicenter Study. HEPATOLOGY, 73(6 (June 2021)), 2099-2109 [10.1002/hep.31797].|
|Tipo:||Articolo in rivista - Articolo scientifico|
|Carattere della pubblicazione:||Scientifica|
|Presenza di un coautore afferente ad Istituzioni straniere:||Si|
|Titolo:||Outcome of COVID-19 in Patients With Autoimmune Hepatitis: An International Multicenter Study|
|Autori:||Efe, C; Dhanasekaran, R; Lammert, C; Ebik, B; Higuera-de la Tijera, F; Aloman, C; Riza Caliskan, A; Peralta, M; Gerussi, A; Massoumi, H; Catana, A; Torgutalp, M; Purnak, T; Rigamonti, C; Gomez Aldana, A; Khakoo, N; Kacmaz, H; Nazal, L; Frager, S; Demir, N; Irak, K; Ellik, Z; Balaban, Y; Atay, K; Eren, F; Cristoferi, L; Batibay, E; Urzua, A; Snijders, R; Kiyici, M; Akyildiz, M; Ekin, N; Carr, R; Harputluoglu, M; Hatemi, I; Mendizabal, M; Silva, M; Idilman, R; Silveira, M; Drenth, J; Assis, D; Bjornsson, E; Boyer, J; Invernizzi, P; Levy, C; Schiano, T; Ridruejo, E; Wahlin, S|
|Data di pubblicazione:||2021|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1002/hep.31797|
|Appare nelle tipologie:||01 - Articolo su rivista|