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

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dc.contributor.authorEfe, Cumali
dc.contributor.authorLammert, Craig
dc.contributor.authorTascilar, Koray
dc.contributor.authorDhanasekaran, Renumathy
dc.contributor.authorEbik, Berat
dc.contributor.authorHiguera-de la Tijera, Fatima
dc.contributor.authorCaliskan, Ali R.
dc.date.accessioned2024-02-23T14:24:32Z
dc.date.available2024-02-23T14:24:32Z
dc.date.issued2022
dc.departmentNEÜen_US
dc.description.abstractBackground 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.en_US
dc.description.sponsorshipItalian Ministry of University and Research (MIUR)-Department of Excellence project PREMIA (PREcision MedIcine Approach: bringing biomarker research to clinic)en_US
dc.description.sponsorshipA. Gerussi, L. Cristoferi, and P. Invernizzi acknowledge that this research was partially supported by the Italian Ministry of University and Research (MIUR)-Department of Excellence project PREMIA (PREcision MedIcine Approach: bringing biomarker research to clinic).en_US
dc.identifier.doi10.1111/liv.15121
dc.identifier.endpage614en_US
dc.identifier.issn1478-3223
dc.identifier.issn1478-3231
dc.identifier.issue3en_US
dc.identifier.pmid34846800en_US
dc.identifier.scopus2-s2.0-85121047570en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage607en_US
dc.identifier.urihttps://doi.org/10.1111/liv.15121
dc.identifier.urihttps://hdl.handle.net/20.500.12452/13996
dc.identifier.volume42en_US
dc.identifier.wosWOS:000729531700001en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherWileyen_US
dc.relation.ispartofLiver Internationalen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectAutoimmunityen_US
dc.subjectAzathioprineen_US
dc.subjectBudesonideen_US
dc.subjectLiver Transplantationen_US
dc.subjectMercaptopurineen_US
dc.subjectSars-Cov-2en_US
dc.titleEffects of immunosuppressive drugs on COVID-19 severity in patients with autoimmune hepatitisen_US
dc.typeArticleen_US

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