评估自身免疫性肝炎患者免疫抑制剂使用和COVID-19严重程度之间的关联
Krish Rai1, Karla J Lindquist1, John Kornak1
1Department of Epidemiology and Biostatistics, University of California, San Francisco, CA 94143, United States.
World journal of hepatology
|March 11, 2026
概括
免疫抑制 (IS) 的自身免疫性肝炎 (AIH) 患者表现出不同的COVID-19 (冠状病毒疾病2019) 风险. 普雷尼松与较低的SARS-CoV-2阳性相关,而某些IS组合增加了风险,对死亡率没有影响.
科学领域:
- 免疫学 免疫学 免疫学
- 肝病学 肝病学是一种肝病学.
- 传染性疾病 传染性疾病
背景情况:
- 患有自身免疫性肝炎 (AIH) 的患者通常需要免疫抑制 (IS),这可能会增加他们对冠状病毒疾病2019 (COVID-19) 等感染的严重结果的脆弱性.
- 在感染SARS-CoV-2的AIH患者中,了解与不同类型的IS相关的特定风险对于临床管理至关重要.
研究的目的:
- 检查自身免疫性肝炎 (AIH) 患者免疫抑制 (IS) 类型和COVID-19严重程度之间的关系.
- 利用国家临床队列协作 (N3C) COVID分支机构来分析IS和SARS-CoV-2感染结果之间的关联.
主要方法:
- 对在N3CCOVID分区内被诊断患有COVID-19的AIH患者的分析.
- 调整后勤回归的应用,以评估与SARS-CoV-2感染的IS类型关联.
- 利用考克斯模型来评估SARS-CoV-2感染AIH患者的IS类型与全因死亡率的关联.
主要成果:
- 在15187名AIH患者中,33%的患者暴露于IS,11%的患者检测出SARS-CoV-2阳性.
- 普雷尼松暴露与SARS-CoV-2测试阳性 (OR:0.81) 有负相关性.
- 布德森尼德和阿扎西奥普林 (OR: 1.88) 和普雷迪尼松和塔克罗利斯 (OR: 1.99) 之间的相互作用与SARS-CoV-2阳性显著相关. 没有一种IS类型与所有原因的死亡率有显著联系.
结论:
- 普雷尼松的使用与检测SARS-CoV-2阳性可能性较低有关,而特定的IS剂组合与风险增加有关.
- 在COVID-19的AIH患者中,特定的IS类型和全因死亡率之间没有发现统计学上显著的关联.
- 未来的研究应该探索COVID-19疫苗接种和治疗方法对该患者队列中的结果的影响.
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