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P-106 COVID-19 PRESENTATION AND OUTCOMES IN 33 PATIENTS WITH AUTOIMMUNE HEPATITIS

BACKGROUND AND AIMS: Clinical course of Covid-19 is not yet established in autoimmune hepatitis (AIH). About 25% of our 400 AIH-outpatients from various states in Brazil are using hydrochloroquine (HCQ) for maintenance or treatment with corticosteroids and immunosuppressants (IS). The aim is to desc...

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Autores principales: Fadini Margon, Julia, Raddatz Reis Vilela, Monique, Damasio Moutinho, Bruna, Rodrigues de Figueiredo, Sabrina, Mitiko Deguti, Marta, Benedita Terrabuio, Débora Raquel, Rachid Cançado, Eduardo Luiz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Published by Elsevier España, S.L. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8468375/
http://dx.doi.org/10.1016/j.aohep.2021.100466
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author Fadini Margon, Julia
Raddatz Reis Vilela, Monique
Damasio Moutinho, Bruna
Rodrigues de Figueiredo, Sabrina
Mitiko Deguti, Marta
Benedita Terrabuio, Débora Raquel
Rachid Cançado, Eduardo Luiz
author_facet Fadini Margon, Julia
Raddatz Reis Vilela, Monique
Damasio Moutinho, Bruna
Rodrigues de Figueiredo, Sabrina
Mitiko Deguti, Marta
Benedita Terrabuio, Débora Raquel
Rachid Cançado, Eduardo Luiz
author_sort Fadini Margon, Julia
collection PubMed
description BACKGROUND AND AIMS: Clinical course of Covid-19 is not yet established in autoimmune hepatitis (AIH). About 25% of our 400 AIH-outpatients from various states in Brazil are using hydrochloroquine (HCQ) for maintenance or treatment with corticosteroids and immunosuppressants (IS). The aim is to describe the clinical features and outcomes of COVID-19 in patients with AIH. METHODS: The diagnosis of COVID was confirmed by positive PCR of nasal swab and/or by serological tests. The diagnosis and treatment of COVID was not always made in our service. RESULTS: 33 patients, 85% female, 41±13yr; 88% AIH-1; 54.6% with advanced fibrosis (F3/F4); 81.8% with comorbidities (17 overweight/obesity [BMI 31.8±5.4], 10 arterial hypertension, 8 diabetes, 2 systemic lupus erythematosus [SLE, with renal failure], 1 celiac disease and malnutrition). The most frequent symptoms were cough (20), headache (19), anosmia and myalgia (18), diarrhea (17) and dyspnea (11). IS at infection was 14 azathioprine(AZA)+prednisone(PD), 2 AZA+PD+cyclosporine, 3 Mycophenolate+PD. HCQ was used for maintenance (6) or as a complement of IS (5). Five hospitalized patients received oxygen supplementation (1 endotracheal intubation); 1 was pregnant and 1 received methylprednisolone pulse+immunoglobulin to treat SLE immediately before COVID; 3 were under double IS and 2 HCQ. 23 received antibiotics (19 azithromycin). In 10 patients (9 with normal liver enzymes before COVID) there were IS adjustments: IS withdrawal and increase of PD dosage (6), increase PD dosage (2), IS withdrawal and HCQ prescription (1), AZA withdrawal+decrease PD dose (1). Six of the 10 patients had slight increase of liver enzymes, none liver decompensation. One patient died, with celiac disease who acquired COVID during hospitalization for lymphoma investigation. CONCLUSIONS: It appears that patients under IS for AIH and COVID-19 show outcomes similar to that of non-immunosuppressed population. HCQ does not appear to have a positive impact on preventing or progressing the disease.
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spelling pubmed-84683752021-09-27 P-106 COVID-19 PRESENTATION AND OUTCOMES IN 33 PATIENTS WITH AUTOIMMUNE HEPATITIS Fadini Margon, Julia Raddatz Reis Vilela, Monique Damasio Moutinho, Bruna Rodrigues de Figueiredo, Sabrina Mitiko Deguti, Marta Benedita Terrabuio, Débora Raquel Rachid Cançado, Eduardo Luiz Ann Hepatol Article BACKGROUND AND AIMS: Clinical course of Covid-19 is not yet established in autoimmune hepatitis (AIH). About 25% of our 400 AIH-outpatients from various states in Brazil are using hydrochloroquine (HCQ) for maintenance or treatment with corticosteroids and immunosuppressants (IS). The aim is to describe the clinical features and outcomes of COVID-19 in patients with AIH. METHODS: The diagnosis of COVID was confirmed by positive PCR of nasal swab and/or by serological tests. The diagnosis and treatment of COVID was not always made in our service. RESULTS: 33 patients, 85% female, 41±13yr; 88% AIH-1; 54.6% with advanced fibrosis (F3/F4); 81.8% with comorbidities (17 overweight/obesity [BMI 31.8±5.4], 10 arterial hypertension, 8 diabetes, 2 systemic lupus erythematosus [SLE, with renal failure], 1 celiac disease and malnutrition). The most frequent symptoms were cough (20), headache (19), anosmia and myalgia (18), diarrhea (17) and dyspnea (11). IS at infection was 14 azathioprine(AZA)+prednisone(PD), 2 AZA+PD+cyclosporine, 3 Mycophenolate+PD. HCQ was used for maintenance (6) or as a complement of IS (5). Five hospitalized patients received oxygen supplementation (1 endotracheal intubation); 1 was pregnant and 1 received methylprednisolone pulse+immunoglobulin to treat SLE immediately before COVID; 3 were under double IS and 2 HCQ. 23 received antibiotics (19 azithromycin). In 10 patients (9 with normal liver enzymes before COVID) there were IS adjustments: IS withdrawal and increase of PD dosage (6), increase PD dosage (2), IS withdrawal and HCQ prescription (1), AZA withdrawal+decrease PD dose (1). Six of the 10 patients had slight increase of liver enzymes, none liver decompensation. One patient died, with celiac disease who acquired COVID during hospitalization for lymphoma investigation. CONCLUSIONS: It appears that patients under IS for AIH and COVID-19 show outcomes similar to that of non-immunosuppressed population. HCQ does not appear to have a positive impact on preventing or progressing the disease. Published by Elsevier España, S.L. 2021-09 2021-09-26 /pmc/articles/PMC8468375/ http://dx.doi.org/10.1016/j.aohep.2021.100466 Text en Copyright © 2021 Published by Elsevier España, S.L. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Fadini Margon, Julia
Raddatz Reis Vilela, Monique
Damasio Moutinho, Bruna
Rodrigues de Figueiredo, Sabrina
Mitiko Deguti, Marta
Benedita Terrabuio, Débora Raquel
Rachid Cançado, Eduardo Luiz
P-106 COVID-19 PRESENTATION AND OUTCOMES IN 33 PATIENTS WITH AUTOIMMUNE HEPATITIS
title P-106 COVID-19 PRESENTATION AND OUTCOMES IN 33 PATIENTS WITH AUTOIMMUNE HEPATITIS
title_full P-106 COVID-19 PRESENTATION AND OUTCOMES IN 33 PATIENTS WITH AUTOIMMUNE HEPATITIS
title_fullStr P-106 COVID-19 PRESENTATION AND OUTCOMES IN 33 PATIENTS WITH AUTOIMMUNE HEPATITIS
title_full_unstemmed P-106 COVID-19 PRESENTATION AND OUTCOMES IN 33 PATIENTS WITH AUTOIMMUNE HEPATITIS
title_short P-106 COVID-19 PRESENTATION AND OUTCOMES IN 33 PATIENTS WITH AUTOIMMUNE HEPATITIS
title_sort p-106 covid-19 presentation and outcomes in 33 patients with autoimmune hepatitis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8468375/
http://dx.doi.org/10.1016/j.aohep.2021.100466
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