SARS-CoV-2 vaccination and risk of severe COVID-19 outcomes in patients with autoimmune hepatitis

Efe C, Tascilar K, Gerussi A, Bolis F, Lammert C, Ebik B, Stättermayer AF, Cengiz M, Gökçe DT, Cristoferi L, Peralta M, Massoumi H, Montes P, Cerda E, Rigamonti C, Yapalı S, Adali G, Çalışkan AR, Balaban Y, Eren F, Eşkazan T, Barutçu S, Lytvyak E, Zazueta GM, Kayhan MA, Heurgue-Berlot A, De Martin E, Yavuz A, Bıyık M, Narro GC, Duman S, Hernandez N, Gatselis NK, Aguirre J, Idilman R, Silva M, Mendizabal M, Atay K, Güzelbulut F, Dhanasekaran R, Montano-Loza AJ, Dalekos GN, Ridruejo E, Invernizzi P, Wahlin S (2022)

Publication Type: Journal article

Publication year: 2022


Book Volume: 132

Article Number: 102906

DOI: 10.1016/j.jaut.2022.102906


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 SARS-CoV-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.

Authors with CRIS profile

Involved external institutions

Gülhane Training and Research Hospital / Gülhane Eğitim ve Araştırma Hastanesi (GEAH) TR Turkey (TR) Uludag University / Uludağ Üniversitesi TR Turkey (TR) Centre hospitalier universitaire de Reims (CHU de Reims) FR France (FR) Adıyaman Üniversitesi TR Turkey (TR) École Polytechnique - Université Paris-Saclay FR France (FR) Ankara University / Ankara Üniversitesi TR Turkey (TR) Hospital Central Militar Mexico / Central Military Hospital MX Mexico (MX) University of Eastern Piedmont / Università degli Studi del Piemonte Orientale "Amedeo Avogadro" IT Italy (IT) University of Milano-Bicocca / Università degli Studi di Milano-Bicocca, UNIMIB IT Italy (IT) Hospital Muñiz / Hospital de Infecciosas Francisco Javier Muñiz AR Argentina (AR) Harran Üniversitesi TR Turkey (TR) Ankara City Hospital / Ankara Şehir Hastanesi TR Turkey (TR) Diyarbakir Gazi Yasargil Education and Research Hospital TR Turkey (TR) Stanford University US United States (USA) (US) Indiana University Health / Clarian Health Partners US United States (USA) (US) Medizinische Universität Wien AT Austria (AT) Acıbadem Mehmet Ali Aydınlar University / Acıbadem Mehmet Ali Aydınlar Üniversitesi TR Turkey (TR) Mardin State Hospital TR Turkey (TR) University of Alberta CA Canada (CA) Hospital Nacional Daniel Alcides Carrión PE Peru (PE) General University Hospital of Larissa GR Greece (GR) Latin American Liver Research Educational and Awareness Network (LALREAN) AR Argentina (AR) Montefiore Medical Center US United States (USA) (US) Hospital Angeles Pedregal MX Mexico (MX) Necmettin Erbakan Üniversitesi TR Turkey (TR) Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán MX Mexico (MX) Karolinska University Hospital / Karolinska Universitetssjukhuset SE Sweden (SE) Hacettepe University TR Turkey (TR) Umrani̇ye Training and Research Hospital / Ümraniye Eğitim ve Araştırma Hastanesi TR Turkey (TR) Gaziantep University / Gaziantep Üniversitesi TR Turkey (TR) İstanbul Eğitim ve Araştırma Hastanesi TR Turkey (TR) Istanbul University Cerrahpaşa / İstanbul Üniversitesi Cerrahpaşa (IUC) TR Turkey (TR) University of the Republic / Universidad de la República (UdelaR) UY Uruguay (UY)

How to cite


Efe, C., Tascilar, K., Gerussi, A., Bolis, F., Lammert, C., Ebik, B.,... Wahlin, S. (2022). SARS-CoV-2 vaccination and risk of severe COVID-19 outcomes in patients with autoimmune hepatitis. Journal of Autoimmunity, 132.


Efe, Cumali, et al. "SARS-CoV-2 vaccination and risk of severe COVID-19 outcomes in patients with autoimmune hepatitis." Journal of Autoimmunity 132 (2022).

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