tetano
Editor, Senior Moderator
J Autoimmun
. 2022 Sep 7;132:102906.
doi: 10.1016/j.jaut.2022.102906. Online ahead of print.
SARS-CoV-2 vaccination and risk of severe COVID-19 outcomes in patients with autoimmune hepatitis
Cumali Efe[SUP] 1 [/SUP], Koray Taşçılar[SUP] 2 [/SUP], Alessio Gerussi[SUP] 3 [/SUP], Francesca Bolis[SUP] 4 [/SUP], Craig Lammert[SUP] 5 [/SUP], Berat Ebik[SUP] 6 [/SUP], Albert Friedrich Stättermayer[SUP] 7 [/SUP], Mustafa Cengiz[SUP] 8 [/SUP], Dilara Turan Gökçe[SUP] 9 [/SUP], Laura Cristoferi[SUP] 3 [/SUP], Mirta Peralta[SUP] 10 [/SUP], Hatef Massoumi[SUP] 11 [/SUP], Pedro Montes[SUP] 12 [/SUP], Eira Cerda[SUP] 13 [/SUP], Cristina Rigamonti[SUP] 14 [/SUP], Suna Yapalı[SUP] 15 [/SUP], Gupse Adali[SUP] 16 [/SUP], Ali Rıza Çalışkan[SUP] 17 [/SUP], Yasemin Balaban[SUP] 18 [/SUP], Fatih Eren[SUP] 19 [/SUP], Tuğçe Eşkazan[SUP] 20 [/SUP], Sezgin Barutçu[SUP] 21 [/SUP], Ellina Lytvyak[SUP] 22 [/SUP], Godolfino Miranda Zazueta[SUP] 23 [/SUP], Meral Akdogan Kayhan[SUP] 8 [/SUP], Alexandra Heurgue-Berlot[SUP] 24 [/SUP], Eleonora De Martin[SUP] 25 [/SUP], Ahmet Yavuz[SUP] 26 [/SUP], Murat Bıyık[SUP] 26 [/SUP], Graciela Castro Narro[SUP] 23 [/SUP], Serkan Duman[SUP] 27 [/SUP], Nelia Hernandez[SUP] 28 [/SUP], Nikolaos K Gatselis[SUP] 29 [/SUP], Jonathan Aguirre[SUP] 30 [/SUP], Ramazan Idilman[SUP] 27 [/SUP], Marcelo Silva[SUP] 31 [/SUP], Manuel Mendizabal[SUP] 31 [/SUP], Kadri Atay[SUP] 32 [/SUP], Fatih Güzelbulut[SUP] 33 [/SUP], Renumathy Dhanasekaran[SUP] 34 [/SUP], Aldo J Montano-Loza[SUP] 22 [/SUP], George N Dalekos[SUP] 29 [/SUP], Ezequiel Ridruejo[SUP] 35 [/SUP], Pietro Invernizzi[SUP] 3 [/SUP], Staffan Wahlin[SUP] 36 [/SUP]
Affiliations
Abstract
Background: Data regarding outcome of Coronavirus disease 2019 (COVID-19) in vaccinated patients with autoimmune hepatitis (AIH) are lacking. We evaluated the outcome of COVID-19 in AIH patients who received at least one dose of Pfizer- BioNTech (BNT162b2), Moderna (mRNA-1273) or AstraZeneca (ChAdOx1-S) vaccine.
Patients and methods: We performed a retrospective study on AIH patients with COVID-19. The outcomes of AIH patients who had acute respiratory syndrome coronavirus 2 (SARS-CoV-2) breakthrough infection after at least one dose of COVID-19 vaccine were compared to unvaccinated patients with AIH. COVID-19 outcome was classified according to clinical state during the disease course 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 data was analyzed using ordinal logistic regression.
Results: We included 413 (258 unvaccinated and 155 vaccinated) patients (81%, female) with a median age of 52 (range: 17-85) years at COVID-19 diagnosis. The rates of hospitalization were (36.4% vs. 14.2%), need for any supplemental oxygen (29.5% vs. 9%) and mortality (7% vs. 0.6%) in unvaccinated and vaccinated AIH patients with COVID-19. Having received at least one dose of SARS-CoV-2 vaccine was associated with a significantly lower risk of worse COVID-19 severity, after adjusting for age, sex, comorbidities and presence of cirrhosis (adjusted odds ratio [aOR] 0.18, 95% confidence interval [CI], 0.10-0.31). Overall, vaccination against SARS-CoV-2 was associated with a significantly lower risk of mortality from COVID-19 (aOR 0.20, 95% CI 0.11-0.35).
Conclusions: SARS-CoV-2 vaccination significantly reduced the risk of COVID-19 severity and mortality in patients with AIH.
Keywords: Autoimmunity; Breakthrough infection; Immunosuppression; Liver failure; Vaccine.
. 2022 Sep 7;132:102906.
doi: 10.1016/j.jaut.2022.102906. Online ahead of print.
SARS-CoV-2 vaccination and risk of severe COVID-19 outcomes in patients with autoimmune hepatitis
Cumali Efe[SUP] 1 [/SUP], Koray Taşçılar[SUP] 2 [/SUP], Alessio Gerussi[SUP] 3 [/SUP], Francesca Bolis[SUP] 4 [/SUP], Craig Lammert[SUP] 5 [/SUP], Berat Ebik[SUP] 6 [/SUP], Albert Friedrich Stättermayer[SUP] 7 [/SUP], Mustafa Cengiz[SUP] 8 [/SUP], Dilara Turan Gökçe[SUP] 9 [/SUP], Laura Cristoferi[SUP] 3 [/SUP], Mirta Peralta[SUP] 10 [/SUP], Hatef Massoumi[SUP] 11 [/SUP], Pedro Montes[SUP] 12 [/SUP], Eira Cerda[SUP] 13 [/SUP], Cristina Rigamonti[SUP] 14 [/SUP], Suna Yapalı[SUP] 15 [/SUP], Gupse Adali[SUP] 16 [/SUP], Ali Rıza Çalışkan[SUP] 17 [/SUP], Yasemin Balaban[SUP] 18 [/SUP], Fatih Eren[SUP] 19 [/SUP], Tuğçe Eşkazan[SUP] 20 [/SUP], Sezgin Barutçu[SUP] 21 [/SUP], Ellina Lytvyak[SUP] 22 [/SUP], Godolfino Miranda Zazueta[SUP] 23 [/SUP], Meral Akdogan Kayhan[SUP] 8 [/SUP], Alexandra Heurgue-Berlot[SUP] 24 [/SUP], Eleonora De Martin[SUP] 25 [/SUP], Ahmet Yavuz[SUP] 26 [/SUP], Murat Bıyık[SUP] 26 [/SUP], Graciela Castro Narro[SUP] 23 [/SUP], Serkan Duman[SUP] 27 [/SUP], Nelia Hernandez[SUP] 28 [/SUP], Nikolaos K Gatselis[SUP] 29 [/SUP], Jonathan Aguirre[SUP] 30 [/SUP], Ramazan Idilman[SUP] 27 [/SUP], Marcelo Silva[SUP] 31 [/SUP], Manuel Mendizabal[SUP] 31 [/SUP], Kadri Atay[SUP] 32 [/SUP], Fatih Güzelbulut[SUP] 33 [/SUP], Renumathy Dhanasekaran[SUP] 34 [/SUP], Aldo J Montano-Loza[SUP] 22 [/SUP], George N Dalekos[SUP] 29 [/SUP], Ezequiel Ridruejo[SUP] 35 [/SUP], Pietro Invernizzi[SUP] 3 [/SUP], Staffan Wahlin[SUP] 36 [/SUP]
Affiliations
- PMID: 36088883
- DOI: 10.1016/j.jaut.2022.102906
Abstract
Background: Data regarding outcome of Coronavirus disease 2019 (COVID-19) in vaccinated patients with autoimmune hepatitis (AIH) are lacking. We evaluated the outcome of COVID-19 in AIH patients who received at least one dose of Pfizer- BioNTech (BNT162b2), Moderna (mRNA-1273) or AstraZeneca (ChAdOx1-S) vaccine.
Patients and methods: We performed a retrospective study on AIH patients with COVID-19. The outcomes of AIH patients who had acute respiratory syndrome coronavirus 2 (SARS-CoV-2) breakthrough infection after at least one dose of COVID-19 vaccine were compared to unvaccinated patients with AIH. COVID-19 outcome was classified according to clinical state during the disease course 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 data was analyzed using ordinal logistic regression.
Results: We included 413 (258 unvaccinated and 155 vaccinated) patients (81%, female) with a median age of 52 (range: 17-85) years at COVID-19 diagnosis. The rates of hospitalization were (36.4% vs. 14.2%), need for any supplemental oxygen (29.5% vs. 9%) and mortality (7% vs. 0.6%) in unvaccinated and vaccinated AIH patients with COVID-19. Having received at least one dose of SARS-CoV-2 vaccine was associated with a significantly lower risk of worse COVID-19 severity, after adjusting for age, sex, comorbidities and presence of cirrhosis (adjusted odds ratio [aOR] 0.18, 95% confidence interval [CI], 0.10-0.31). Overall, vaccination against SARS-CoV-2 was associated with a significantly lower risk of mortality from COVID-19 (aOR 0.20, 95% CI 0.11-0.35).
Conclusions: SARS-CoV-2 vaccination significantly reduced the risk of COVID-19 severity and mortality in patients with AIH.
Keywords: Autoimmunity; Breakthrough infection; Immunosuppression; Liver failure; Vaccine.