{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T22:15:11Z","timestamp":1785795311949,"version":"3.56.0"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T00:00:00Z","timestamp":1639353600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>We investigated associations between baseline use of immunosuppressive drugs and severity of Coronavirus Disease 2019 (COVID\u201019) in autoimmune hepatitis (AIH).<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>Data of AIH patients with laboratory confirmed COVID\u201019 were retrospectively collected from 15 countries. The outcomes of AIH patients who were on immunosuppression at the time of COVID\u201019 were compared to patients who were not on AIH medication. The clinical courses of COVID\u201019 were classified as (i)\u2010no hospitalization, (ii)\u2010hospitalization without oxygen supplementation, (iii)\u2010hospitalization with oxygen supplementation by nasal cannula or mask, (iv)\u2010intensive care unit (ICU) admission with non\u2010invasive mechanical ventilation, (v)\u2010ICU admission with invasive mechanical ventilation or (vi)\u2010death and analysed using ordinal logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 254 AIH patients (79.5%, female) with a median age of 50 (range, 17\u201085) years. At the onset of COVID\u201019, 234 patients (92.1%) were on treatment with glucocorticoids (n\u00a0=\u00a0156), thiopurines (n\u00a0=\u00a0151), mycophenolate mofetil (n\u00a0=\u00a022) or tacrolimus (n\u00a0=\u00a016), alone or in combinations. Overall, 94 (37%) patients were hospitalized and 18 (7.1%) patients died. Use of systemic glucocorticoids (adjusted odds ratio [aOR] 4.73, 95% CI 1.12\u201025.89) and thiopurines (aOR 4.78, 95% CI 1.33\u201023.50) for AIH was associated with worse COVID\u201019 severity, after adjusting for age\u2010sex, comorbidities and presence of cirrhosis. Baseline treatment with mycophenolate mofetil (aOR 3.56, 95% CI 0.76\u201020.56) and tacrolimus (aOR 4.09, 95% CI 0.69\u201027.00) were also associated with more severe COVID\u201019 courses in a smaller subset of treated patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Baseline treatment with systemic glucocorticoids or thiopurines prior to the onset of COVID\u201019 was significantly associated with COVID\u201019 severity in patients with AIH.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.15121","type":"journal-article","created":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T23:10:32Z","timestamp":1638313832000},"page":"607-614","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Effects of immunosuppressive drugs on COVID\u201019 severity in patients with autoimmune hepatitis"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6593-5702","authenticated-orcid":false,"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\/0000-0003-3809-640X","authenticated-orcid":false,"given":"Craig","family":"Lammert","sequence":"additional","affiliation":[{"name":"Department of Medicine Indiana University School of Medicine Indianapolis Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koray","family":"Ta\u015f\u00e7\u0131lar","sequence":"additional","affiliation":[{"name":"Department of Medicine 3\u2010Rheumatology and Immunology Friedrich\u2010Alexander University (FAU) Erlangen\u2010N\u00fcrnberg and Universit\u00e4tsklinikum Erlangen Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8819-7511","authenticated-orcid":false,"given":"Renumathy","family":"Dhanasekaran","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Medicine Stanford University Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berat","family":"Ebik","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Gazi Ya\u015fargil Education and Research Hospital Diyarbakir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima","family":"Higuera\u2010de la Tijera","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Unit Hospital General de M\u00e9xico Ciudad de M\u00e9xico M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali R.","family":"Cal\u0131\u015fkan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Ad\u0131yaman University Ad\u0131yaman Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirta","family":"Peralta","sequence":"additional","affiliation":[{"name":"Hepatology Section Hospital Francisco J Mu\u00f1iz Ciudad Aut\u00f3noma de Buenos Aires Argentina"},{"name":"Latin American Liver Research Educational and Awareness Network (LALREAN) Pilar Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio","family":"Gerussi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Center for Autoimmune Liver Diseases Department of Medicine and Surgery University of Milano\u2010Bicocca Monza Italy"},{"name":"European Reference Network on Hepatological Diseases (ERN RARE\u2010LIVER) San Gerardo Hospital Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hatef","family":"Massoumi","sequence":"additional","affiliation":[{"name":"Department of Medicine Montefiore Medical Center Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreea M.","family":"Catana","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology\/Hepatology Department of Medicine Beth Israel Deaconess Medical Center Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tugrul","family":"Purnak","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition McGovern Medical School Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Rigamonti","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine Universit\u00e0 del Piemonte Orientale UPO Novara Italy"},{"name":"Division of Internal Medicine \"AOU Maggiore della Carit\u00e0\" Novara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andres J. 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