{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T01:53:09Z","timestamp":1790819589899,"version":"4.1.0"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T00:00:00Z","timestamp":1655942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T00:00:00Z","timestamp":1655942400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background and Aims<\/jats:title>\n            <jats:p>A few case reports of autoimmune hepatitis\u2013like liver injury have been reported after severe acute respiratory syndrome coronavirus 2 (SARS\u2010CoV\u20102) vaccination. We evaluated clinical features, treatment response and outcomes of liver injury following SARS\u2010CoV\u20102 vaccination in a large case series.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Approach and Results<\/jats:title>\n            <jats:p>We collected data from cases in 18 countries. The type of liver injury was assessed with the R\u2010value. The study population was categorized according to features of immune\u2010mediated hepatitis (positive autoantibodies and elevated immunoglobulin G levels) and corticosteroid therapy for the liver injury. We identified 87 patients (63%, female), median age 48 (range: 18\u201379) years at presentation. Liver injury was diagnosed a median 15 (range: 3\u201365) days after vaccination. Fifty\u2010one cases (59%) were attributed to the Pfizer\u2010BioNTech (BNT162b2) vaccine, 20 (23%) cases to the Oxford\u2010AstraZeneca (ChAdOX1 nCoV\u201019) vaccine and 16 (18%) cases to the Moderna (mRNA\u20101273) vaccine. The liver injury was predominantly hepatocellular (84%) and 57% of patients showed features of immune\u2010mediated hepatitis. Corticosteroids were given to 46 (53%) patients, more often for grade 3\u20134 liver injury than for grade 1\u20132 liver injury (88.9% vs. 43.5%, <jats:italic toggle=\"yes\">p<\/jats:italic>\u00a0=\u00a00.001) and more often for patients with than without immune\u2010mediated hepatitis (71.1% vs. 38.2%, <jats:italic toggle=\"yes\">p<\/jats:italic>\u00a0=\u00a00.003). All patients showed resolution of liver injury except for one man (1.1%) who developed liver failure and underwent liver transplantation. Steroid therapy was withdrawn during the observation period in 12 (26%) patients after complete biochemical resolution. None had a relapse during follow\u2010up.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>SARS\u2010CoV\u20102 vaccination can be associated with liver injury. Corticosteroid therapy may be beneficial in those with immune\u2010mediated features or severe hepatitis. Outcome was generally favorable, but vaccine\u2010associated liver injury led to fulminant liver failure in one patient.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.32572","type":"journal-article","created":{"date-parts":[[2022,5,14]],"date-time":"2022-05-14T13:39:36Z","timestamp":1652535576000},"page":"1576-1586","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":105,"title":["Liver injury after SARS\u2010CoV\u20102 vaccination: Features of immune\u2010mediated hepatitis, role of corticosteroid therapy and outcome"],"prefix":"10.1097","volume":"76","author":[{"given":"Cumali","family":"Efe","sequence":"first","affiliation":[{"name":"Department of Gastroenterology,Harran University Hospital,\u015eanl\u0131urfa,Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1240-1675","authenticated-orcid":false,"given":"Anand V.","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Liver Transplantation,Asian Institute of Gastroenterology Hospitals,Hyderabad,India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5004-5029","authenticated-orcid":false,"given":"Benedetta","family":"Terziroli Beretta\u2010Piccoli","sequence":"additional","affiliation":[{"name":"Faculty of Biomedical Sciences,Universit\u00e0 Della Svizzera Italiana,Lugano,Switzerland"},{"name":"Epatocentro Ticino,Lugano,Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6417-3205","authenticated-orcid":false,"given":"Bianca","family":"Magro","sequence":"additional","affiliation":[{"name":"Gastroenterology Hepatology and Transplantation,ASST Papa Giovanni XXIII\u2010Bergamo,Bergamo,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"St\u00e4ttermayer","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Internal Medicine III,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Cengiz","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology,G\u00fclhane Training and Research Hospital,Ankara,Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7479-9669","authenticated-orcid":false,"given":"Daniel","family":"Clayton\u2010Chubb","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology,Alfred Health,Melbourne,Victoria,Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3809-640X","authenticated-orcid":false,"given":"Craig","family":"Lammert","sequence":"additional","affiliation":[{"name":"Department of Medicine Indiana,University School of Medicine,Indianapolis,Indiana,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Bernsmeier","sequence":"additional","affiliation":[{"name":"Department of Biomedicine,University of Basel,Basel,Switzerland"},{"name":"University Centre for Gastrointestinal and Liver Diseases,Basel,Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6zlem","family":"G\u00fcl","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology,K\u0131r\u0131kkale University,K\u0131r\u0131kkale,Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima Higuera\u2010de","family":"la 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