SARS-CoV-2 vaccination and risk of severe COVID-19 outcomes in patients with autoimmune hepatitis.
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Efe Cumali, Taşçılar Koray, Gerussi Alessio, Bolis Francesca, Lammert Craig, Ebik Berat, Stättermayer Albert Friedrich, Cengiz Mustafa, Gökçe Dilara Turan, Cristoferi Laura, Peralta Mirta, Massoumi Hatef, Montes Pedro, Cerda Eira, Rigamonti Cristina, Yapalı Suna, Adali Gupse, Çalışkan Ali Rıza, Balaban Yasemin, Eren Fatih, Eşkazan Tuğçe, Barutçu Sezgin, Lytvyak Ellina, Zazueta Godolfino Miranda, Kayhan Meral Akdogan, Heurgue-Berlot Alexandra, De Martin Eleonora, Yavuz Ahmet, Bıyık Murat, Narro Graciela Castro, Duman Serkan, Hernandez Nelia, Gatselis Nikolaos K, Aguirre Jonathan, Idilman Ramazan, Silva Marcelo, Mendizabal Manuel, Atay Kadri, Güzelbulut Fatih, Dhanasekaran Renumathy, Montano-Loza Aldo J, Dalekos George N, Ridruejo Ezequiel, Invernizzi Pietro, Wahlin Staffan
Аннотация
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.