Primary biliary cholangitis and SARS-CoV-2 infection: incidence, susceptibility and outcomes

Letter to the editor: vaccination against upper respiratory infections is a matter of survival in alcoholic liver disease

“…We read with great interest the report on SARS-CoV-2 infection in patients with primary biliary cholangitis (PBC) by Ampuero et al . 1 An independent association of chronic liver disease with adverse clinical outcome in patients with COVID-19 was previously reported in this journal. 2 However, the impact of SARS-CoV-2 and upper airway infections in general on patients with alcoholic liver disease (ALD) remains widely unknown.…”

“…We read with great interest the report on SARS-CoV-2 infection in patients with primary biliary cholangitis (PBC) by Ampuero et al 1. An independent association of chronic liver disease with adverse clinical outcome in patients with COVID-19 was previously reported in this journal 2.…”

Impact of COVID-19 on the liver and on the care of patients with chronic liver disease, hepatobiliary cancer, and liver transplantation: An updated EASL position paper

“…Data for patients with primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) are limited. One Nationwide study in Spain did observe a higher cumulative incidence of hospitalization and mortality in patients with PBC compared with the general population although interpretations are limited by the lack of adjustment for co-morbidities [ 89 ].

EASL position Patients with autoimmune hepatitis on immunosuppression do not appear to be at a higher risk of SARS-CoV-2 infection or COVID 19 related mortality.

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COVID-19 and liver disease

“…However, a larger retrospective study from the same group, including 254 patients with AIH with COVID-19, did show that baseline treatment with systemic glucocorticoids (median dose: 5 mg/day) or azathioprine (median dose: 75 mg/day) was associated with COVID-19 severity compared with no treatment 85. Data for patients with PBC and primary sclerosing cholangitis (PSC) are limited, although one nationwide study in Spain did observe a higher cumulative incidence of hospitalisation and mortality in patients with PBC compared with the general population although interpretations are limited by the lack of adjustment for comorbidities 86…”