SARS-CoV-2 vaccination and risk of severe COVID-19 outcomes in patients with autoimmune hepatitis.

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.

• Authors: Cumali Efe, Koray Taşçılar, Alessio Gerussi, Francesca Bolis, Craig Lammert, Berat Ebik, Albert Friedrich Stättermayer, Mustafa Cengiz, Dilara Turan Gökçe, Laura Cristoferi, Mirta Peralta, Hatef Massoumi, Pedro Montes, Eira Cerda, Cristina Rigamonti, Suna Yapalı, Gupse Adali, Ali Rıza Çalışkan, Yasemin Balaban, Fatih Eren, Tuğçe Eşkazan, Sezgin Barutçu, Ellina Lytvyak, Godolfino Miranda Zazueta, Meral Akdogan Kayhan, Alexandra Heurgue-Berlot, Eleonora De Martin, Ahmet Yavuz, Murat Bıyık, Graciela Castro Narro, Serkan Duman, Nelia Hernandez, Nikolaos K Gatselis, Jonathan Aguirre, Ramazan Idilman, Marcelo Silva, Manuel Mendizabal, Kadri Atay, Fatih Güzelbulut, Renumathy Dhanasekaran, Aldo J Montano-Loza, George N Dalekos, Ezequiel Ridruejo, Pietro Invernizzi, Staffan Wahlin
• Journal: Journal of autoimmunity (J Autoimmun) Vol. 132 Pg. 102906 (10 2022) ISSN: 1095-9157 [Electronic] England
• PMID: 36088883 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2022 Elsevier Ltd. All rights reserved.

Chemical References

• COVID-19 Vaccines
• BNT162 Vaccine

Topics

• Humans
• Female
• Adolescent
• Young Adult
• Adult
• Middle Aged
• Aged
• Aged, 80 and over
• Male
• COVID-19 (epidemiology, prevention & control)
• SARS-CoV-2
• COVID-19 Vaccines
• Hepatitis, Autoimmune
• Retrospective Studies
• BNT162 Vaccine
• COVID-19 Testing
• Vaccination