Liver injury after SARS-CoV-2 vaccination: Features of immune-mediated hepatitis, role of corticosteroid therapy and outcome

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dc.authoridKumar, Rahul/0000-0002-5092-4821
dc.authoridAndroutsakos, Theodoros/0000-0003-2556-6230
dc.authoridRoberts, Stuart/0000-0002-9015-7997
dc.authoridCagin, Yasir Furkan/0000-0002-2538-857X
dc.authoridLytvyak, Ellina/0000-0001-5651-9010
dc.authoridTerziroli Beretta-Piccoli, Benedetta/0000-0001-5004-5029
dc.authoridGuzelbulut, Fatih/0000-0003-4889-208X
dc.contributor.authorEfe, Cumali
dc.contributor.authorKulkarni, Anand V.
dc.contributor.authorTerziroli Beretta-Piccoli, Benedetta
dc.contributor.authorMagro, Bianca
dc.contributor.authorFriedrich Staettermayer, Albert
dc.contributor.authorCengiz, Mustafa
dc.contributor.authorClayton-Chubb, Daniel
dc.date.accessioned2025-01-21T16:42:22Z
dc.date.available2025-01-21T16:42:22Z
dc.date.issued2022
dc.departmentKırıkkale Üniversitesi
dc.description.abstractBackground and Aims A few case reports of autoimmune hepatitis-like liver injury have been reported after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. We evaluated clinical features, treatment response and outcomes of liver injury following SARS-CoV-2 vaccination in a large case series. Approach and Results We collected data from cases in 18 countries. The type of liver injury was assessed with the R-value. The study population was categorized according to features of immune-mediated hepatitis (positive autoantibodies and elevated immunoglobulin G levels) and corticosteroid therapy for the liver injury. We identified 87 patients (63%, female), median age 48 (range: 18-79) years at presentation. Liver injury was diagnosed a median 15 (range: 3-65) days after vaccination. Fifty-one cases (59%) were attributed to the Pfizer-BioNTech (BNT162b2) vaccine, 20 (23%) cases to the Oxford-AstraZeneca (ChAdOX1 nCoV-19) vaccine and 16 (18%) cases to the Moderna (mRNA-1273) vaccine. The liver injury was predominantly hepatocellular (84%) and 57% of patients showed features of immune-mediated hepatitis. Corticosteroids were given to 46 (53%) patients, more often for grade 3-4 liver injury than for grade 1-2 liver injury (88.9% vs. 43.5%, p = 0.001) and more often for patients with than without immune-mediated hepatitis (71.1% vs. 38.2%, p = 0.003). All patients showed resolution of liver injury except for one man (1.1%) who developed liver failure and underwent liver transplantation. Steroid therapy was withdrawn during the observation period in 12 (26%) patients after complete biochemical resolution. None had a relapse during follow-up. Conclusions SARS-CoV-2 vaccination can be associated with liver injury. Corticosteroid therapy may be beneficial in those with immune-mediated features or severe hepatitis. Outcome was generally favorable, but vaccine-associated liver injury led to fulminant liver failure in one patient.
dc.identifier.doi10.1002/hep.32572
dc.identifier.endpage1586
dc.identifier.issn0270-9139
dc.identifier.issn1527-3350
dc.identifier.issue6
dc.identifier.pmid35567545
dc.identifier.scopus2-s2.0-85132426686
dc.identifier.scopusqualityQ1
dc.identifier.startpage1576
dc.identifier.urihttps://doi.org/10.1002/hep.32572
dc.identifier.urihttps://hdl.handle.net/20.500.12587/25063
dc.identifier.volume76
dc.identifier.wosWOS:000814517500001
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherLippincott Williams & Wilkins
dc.relation.ispartofHepatology
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_20241229
dc.titleLiver injury after SARS-CoV-2 vaccination: Features of immune-mediated hepatitis, role of corticosteroid therapy and outcome
dc.typeArticle

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