Browsing by Author "Cristoferi, Laura"

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    Publication
    Effects of immunosuppressive drugs on COVID-19 severity in patients with autoimmune hepatitis
    (Wiley, 2021-11-28) Efe, Cumali; Lammert, Craig; Taşcılar, Koray; Dhanasekaran, Renumathy; Ebik, Berat; Higuera-de la Tijera, Fatima; Çalışkan, Ali R.; Peralta, Mirta; Gerussi, Alessio; Massoumi, Hatef; Catana, Andreea M.; Purnak, Tuğrul; Rigamonti, Cristina; Aldana, Andres J. G.; Khakoo, Nidah; Nazal, Leyla; Frager, Shalom; Demir, Nurhan; Irak, Kader; Melekoğlu-Ellik, Zeynep; Kaçmaz, Hüseyin; Balaban, Yasemin; Atay, Kadri; Eren, Fatih; Alvares-da-Silva, Mario R.; Cristoferi, Laura; Urzua, Alvaro; Eskazan, Tuğçe; Magro, Bianca; Snijders, Romee; Barutcu, Sezgin; Lytvyak, Ellina; Zazueta, Godolfino M.; Demirezer-Bolat, Aylin; Aydın, Mesut; Heurgue-Berlot, Alexandra; De Martin, Eleonora; Ekin, Nazım; Yıldırım, Sümeyra; Yavuz, Ahmet; Bıyık, Murat; Narro, Graciela C.; Kıyıcı, Murat; Akyıldız, Murat; Kahramanoğlu-Aksoy, Evrim; Vincent, Maria; Carr, Rotonya M.; Günşar, Fulya; Reyes, Eira C.; Harputluoğlu, Murat; Aloman, Costica; Gatselis, Nikolaos K.; Ustundağ, Yücel; Brahm, Javier; Vargas, Nataly C. E.; Güzelbulut, Fatih; Garcia, Sandro R.; Aguirre, Jonathan; Anders, Margarita; Ratusnu, Natalia; Hatemi, İbrahim; Mendizabal, Manuel; Floreani, Annarosa; Fagiuoli, Stefano; Silva, Marcelo; Idılman, Ramazan; Satapathy, Sanjaya K.; Silveira, Marina; Drenth, Joost P. H.; Dalekos, George N.; Assis, David N.; Bjornsson, Einar; Boyer, James L.; Yoshida, Eric M.; Invernizzi, Pietro; Levy, Cynthia; Montano-Loza, Aldo J.; Schiano, Thomas D.; Ridruejo, Ezequiel; Wahlin, Staffan; KIYICI, MURAT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Gastroenteroloji Anabilim Dalı.; FHW-0015-2022
    Background We investigated associations between baseline use of immunosuppressive drugs and severity of Coronavirus Disease 2019 (COVID-19) in autoimmune hepatitis (AIH). Patients and methods Data of AIH patients with laboratory confirmed COVID-19 were retrospectively collected from 15 countries. The outcomes of AIH patients who were on immunosuppression at the time of COVID-19 were compared to patients who were not on AIH medication. The clinical courses of COVID-19 were classified 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 analysed using ordinal logistic regression. Results We included 254 AIH patients (79.5%, female) with a median age of 50 (range, 17-85) years. At the onset of COVID-19, 234 patients (92.1%) were on treatment with glucocorticoids (n = 156), thiopurines (n = 151), mycophenolate mofetil (n = 22) or tacrolimus (n = 16), 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 1.12-25.89) and thiopurines (aOR 4.78, 95% CI 1.33-23.50) for AIH was associated with worse COVID-19 severity, after adjusting for age-sex, comorbidities and presence of cirrhosis. Baseline treatment with mycophenolate mofetil (aOR 3.56, 95% CI 0.76-20.56) and tacrolimus (aOR 4.09, 95% CI 0.69-27.00) were also associated with more severe COVID-19 courses in a smaller subset of treated patients. Conclusion Baseline treatment with systemic glucocorticoids or thiopurines prior to the onset of COVID-19 was significantly associated with COVID-19 severity in patients with AIH.
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    Publication
    SARS-CoV-2 vaccination and risk of severe COVID-19 outcomes in patients with autoimmune hepatitis
    (Academic Press Ltd- Elsevier Science Ltd, 2022-10-01) Efe, Cumali; Tascilar, Koray; Gerussi, Alessio; Bolis, Francesca; Lammert, Craig; Ebik, Berat; Stattermayer, Albert Friedrich; Cengiz, Mustafa; Gokce, Dilara Turan; Cristoferi, Laura; Peralta, Mirta; Massoumi, Hatef; Montes, Pedro; Cerda, Eira; Rigamonti, Cristina; Yapali, Suna; Adali, Gupse; Caliskan, Ali Riza; Balaban, Yasemin; Eren, Fatih; Eskazan, Tugce; Barutcu, Sezgin; Lytvyak, Ellina; Zazueta, Godolfino Miranda; Kayhan, Meral Akdogan; Heurgue-Berlot, Alexandra; De Martin, Eleonora; Yavuz, Ahmet; Biyik, Murat; Narro, Graciela Castro; Duman, Serkan; Hernandez, Nelia; Gatselis, Nikolaos K.; Aguirre, Jonathan; Idilman, Ramazan; Silva, Marcelo; Mendizabal, Manuel; Atay, Kadri; Guzelbulut, Fatih; Dhanasekaran, Renumathy; Montano-Loza, Aldo J.; Dalekos, George N.; Ridruejo, Ezequiel; Invernizzi, Pietro; Wahlin, Staffan; EREN, FATİH; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Gastroenteroloji Anabilim Dalı.; 0000-0003-2667-8963 ; JQJ-3328-2023
    Background: Data regarding outcome of Coronavirus disease 2019 (COVID-19) in vaccinated patients with autoimmune hepatitis (AIH) are lacking. We evaluated the outcome of COVID-19 in AIH patients who received at least one dose of Pfizer- BioNTech (BNT162b2), Moderna (mRNA-1273) or AstraZeneca (ChAdOx1-S) vaccine. 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 SARSCoV-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.