Impact of COVID-19 infection and vaccination in pancreatobiliary IgG4-related disease patients: an international multicenter study

• Main Authors: Tang, Raymond S. Y., Sattayalertyanyong, Onuma, Kuo, Yu-Ting, Park, Kenneth H., Anastassiades, Constantinos, Ligresti, Dario, Hayashi, Nobuhiko, Hasan, Aws, Kim, Tae-Hyeon, Pausawasdi, Nonthalee, Wang, Hsiu-Po, Lo, Simon K., Ho, Khek-Yu, Barresi, Luca, Traina, Mario, Yasuda, Ichiro, Savides, Thomas J., Koo, Chieh-Sian, Chan, Ting Ting, Lam, Thomas Y. T., Sung, Joseph Jao Yiu
• Other Authors: Lee Kong Chian School of Medicine (LKCMedicine)
• Format: Article
• Language: English
• Published: 2023
• Subjects: Science::Medicine; COVID-19 Vaccination; Immunosuppressive Therapy
• Online Access: https://hdl.handle.net/10356/170005
• Institution: Nanyang Technological University

Background and Aim: Dedicated studies evaluating the impact of COVID-19 on out-comes of pancreatobiliary IgG4 related disease (IgG4-RD) patients are scarce. WhetherCOVID-19 infection or vaccination would trigger IgG4-RD exacerbation remains unknown. Methods: Pancreatobiliary IgG4-RD patients≥18 years old with active follow-up since January 2020 from nine referral centers in Asia, Europe, and North America were included in this multicenter retrospective study. Outcome measures include incidence and severity ofCOVID-19 infection, IgG4-RD disease activity and treatment status, interruption of indicated IgG4-RD treatment. Prospective data on COVID-19 vaccination status and newCOVID-19 infection during the Omicron outbreak were also retrieved in the Hong Kong cohort. Results: Of the 124 pancreatobiliary IgG4-RD patients, 25.0% had active IgG4-RD, 71.0%were on immunosuppressive therapies and 80.6% had≥1 risk factor for severe COVID. In2020 (pre-vaccination period), two patients (1.6%) had COVID-19 infection (one requiring ICU admission), and 7.2% of patients had interruptions in indicated immunosuppressive treatment for IgG4-RD. Despite a high vaccination rate (85.0%), COVID-19 infection rate has increased to 20.0% during Omicron outbreak in the Hong Kong cohort. A trend to-wards higher COVID-19 infection rate was noted in the non-fully vaccinated/unvaccinated group (17.6%vs33.3%, P= 0.376). No IgG4-RD exacerbation followingCOVID-19 vaccination or infection was observed. Conclusion: While a low COVID-19 infection rate with no mortality was observed in pancreatobiliary IgG4-RD patients in the pre-vaccination period of COVID-19, infection rate has increased during the Omicron outbreak despite a high vaccination rate. NoIgG4-RD exacerbation after COVID-19 infection or vaccination was observed.