Produção Nacional
Revisado por pares
Effects of immunosuppressive drugs on COVID‐19 severity in patients with autoimmune hepatitis
2021; Wiley; Volume: 42; Issue: 3 Linguagem: Inglês
10.1111/liv.15121
ISSN1478-3231
AutoresCumali Efe, Craig Lammert, Koray Taşçılar, Renumathy Dhanasekaran, Berat Ebik, Fátima Higuera-de la Tijera, Ali Rıza Çalışkan, Mirta Peralta, Alessio Gerussi, Hatef Massoumi, Andreea M. Catana, Tuğrul Pürnak, Cristina Rigamonti, Andrés Gómez-Aldana, Nidah S. Khakoo, Leyla Nazal, Shalom Frager, Nurhan Demir, Kader İrak, Zeynep Melekoğlu‐Ellik, Hüseyin Kaçmaz, Yasemin Balaban, Kadri Atay, Fatih Eren, Mário Reis Álvares‐da‐Silva, Laura Cristoferi, Álvaro Urzúa, Tuğçe Eşkazan, Bianca Magro, Romée J.A.L.M. Snijders, Sezgin Barutçu, Ellina Lytvyak, Godolfino Miranda Zazueta, Aylin Demirezer‐Bolat, Mesut Aydın, Alexandra Heurgué–Berlot, Eléonora De Martin, Nazım Ekin, Sümeyra Yıldırım, Ahmet Yavuz, Murat Bıyık, Graciela Castro Narro, Murat Kıyıcı, Murat Akyıldız, Evrim Kahramanoğlu Aksoy, Maria Vincent, Rotonya M. Carr, Fulya Günşar, Eira Cerda Reyes, Murat Harputluoğlu, Costica Aloman, Nikolaos Gatselis, Yücel Üstündağ, Javier Brahm, Nataly C. E. Vargas, Fatih Güzelbulut, Sandro Ruiz García, Jonathan Aguirre, Margarita Anders, Natalia Ratusnu, İbrahim Hatemı, Manuel Mendizábal, Annarosa Floreani, S. Fagiuoli, Marcelo Silva, Ramazan İdilman, Sanjaya K. Satapathy, Marina G. Silveira, Joost P.H. Drenth, George Ν. Dalekos, David N. Assis, Einar S. Björnsson, James L. Boyer, Eric M. Yoshida, Pietro Invernizzi, Cynthia Levy, Aldo J. Montaño‐Loza, Thomas D. Schiano, Ezequiel Ridruejo, Staffan Wåhlin,
Tópico(s)Liver Disease Diagnosis and Treatment
ResumoWe investigated associations between baseline use of immunosuppressive drugs and severity of Coronavirus Disease 2019 (COVID-19) in autoimmune hepatitis (AIH).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.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.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.
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