Special Considerations in the Management of Autoimmune Hepatitis in COVID-19 Hotspots: A Review

Abstract

The ongoing coronavirus disease-2019 (COVID-19) pandemic has necessitated special considerations in the management of diseases. The way presence of pre-existing diseases or treatment for it predisposes to, alters course of, and changes the management of COVID-19, is of relevance and is being extensively studied. Autoimmune hepatitis (AIH) is unique in that it is an autoimmune disease mandating treatment with immunosuppressive drugs, as well as a liver disease with potential for varying degrees of underlying fibrosis. The use of immunosuppressive drugs could alter the risk of acquiring COVID-19, the clinical course and severity of COVID-19 and the degree of underlying liver fibrosis could alter the clinical outcomes of patients with COVID-19. In this review, we try to summarize key areas relevant in understanding and improving the clinical care of patients with AIH in the current pandemic. Special considerations required in the management of patients with AIH in COVID-19 hotspots have been outlined based on the current evidence.

Characteristics of COVID-19 Infection in a Hospitalized Autoimmune Hepatitis Patient

“…The administration of immunosuppressive drugs could alter clinical and laboratory characteristics for patients with AIH and possibly result in a poorer outcome with the evolution of COVID-19 to a more severe disease. Previous studies have described the risk of acquiring SARS-CoV-2 infection for patients with autoimmune diseases, especially those being treated with immunomodulators [1,2]. COVID-19 pandemic has reached approximately 551 million individuals worldwide [3].…”