Behaviors, symptoms, and outcomes of North American patients with autoimmune hepatitis during the COVID-19 pandemic. (December 2021)

• Record Type: Journal Article
• Authors: Vuppalanchi, Vahin; Gelow, Kayla; Green, Kelsey; Vuppalanchi, Raj; Lammert, Craig
• Is Part Of: Journal of investigative medicine. Volume 69:Number 8(2021)
• Page Start: 1426
• Page End: 1433
• Publication Date: 2021-12
• Subjects: COVID-19 -- SARS-CoV-2 -- autoimmune hepatitis -- AIH -- immunosuppression; Clinical medicine -- Periodicals; Medicine -- Research -- Periodicals; Medicine; Research -- United States; Clinical medicine; Medicine -- Research; Periodicals; 616.075
• DOI: 10.1136/jim-2021-001871
• Languages: English
• ISSNs: 1081-5589

Abstract

The management of patients with autoimmune hepatitis (AIH) in the era of SARS-CoV-2 is challenging given minimal published clinical data. We used a large cohort of patients with AIH across the USA to investigate the differences in known risk factors for severe SARS-CoV-2 and AIH characteristics among patients who experienced symptoms consistent with COVID-19 illness versus those who did not. Additionally, we explored the effect of living through the SARS-CoV-2 pandemic on the extrahepatic symptoms and behaviors of patients with AIH. An invitation to complete a COVID-19-specific questionnaire was publicized in well-established social media cohorts of patients with AIH. Eligibility criteria were age ≥18 years, US residency, and an AIH diagnosis by a physician. A total of 420 individuals were eligible for the study. Symptoms consistent with COVID-19 were reported in 11% (n=48) with 3 patients requiring hospitalizations. Body mass index (BMI) >40 kg/m 2 (23% vs 10%, p = 0.01) and exposure to house (33% vs 3%, p=0.0001) or work (38% vs 17%, p = 0.02) contacts with COVID-19 were factors found higher in those with symptoms. Cirrhosis or steroid use or immunosuppression was not significantly different between symptomatic and non-symptomatic groups. Worsening fatigue (45% vs 30%, p=0.06), anxiety (89% vs 70%, p=0.08), and itch (40% vs 18%, p=0.03) were more common among those reporting COVID-19 symptoms compared with those without. BMI >40 kg/m 2 and exposure to contacts with COVID-19 illness but not cirrhosis or immunosuppression were associated with increased risk of COVID-19 illness in patients with AIH.