Comparison of Patients with and without Coronavirus-19 Infection in Terms of Acquired Immune Response to Hepatitis A: A Retrospective Study
Öz
Objective: This study aimed to examine whether there is a difference in the level of immune response against hepatitis A virus between patients with and
without COVID-19 infection.
Materials and Methods: Fifty patients with COVID-19 disease (confirmed by PCR positivity) who were followed in our clinic between 1 June 2020 and 1
September 2020 were enrolled in this cross-sectional, retrospective, single-center study. A total of 150 patients, who had similar demographic characteristics
and were randomly selected among the patients who Anti HAV IgG levels were determined during their admission to our clinic in the last two years before
the pandemic (November 1, 2017-November 1, 2019) were taken as the control group. Anti-HAV IgG seropositivity rates and serum antibody titers were
compared between these two groups.
Results: The median age of the 200 cases was 48.5 (25.-75.Quartiles=43.0-59.0) years, 108 (54%) were male and 92 (46%) were female. One hundred, and
forty-two of the cases were 60 years and above, but the proportion of the patients aged 60 and over in the patient groups was similar (p=0.105). Although
anti-HAV IgG seropositivity rates in COVID-19 patients were similar to cases in the control group (p=0.062), anti-HAV IgG titers in COVID-19 cases were
found to be significantly lower than in control patients (p<0.001). Anti-HAV IgG titers were found to be significantly lower in critical COVID-19 patients
(n=7) compared to other COVID-19 patients (n=43, p=0.049). In addition, it was observed that there was a significant and strong correlation between the
anti-HAV IgG titer and the presence of critical COVID-19 disease (η=0.988).
Conclusion: Although our results seem to support the thesis that the presence of HAV vaccine or previous HAV infection may be protective against COVID-
19 infection, especially in terms of preventing critical disease course, prospective studies with larger patient series are needed to confirm these results.ed to confirm these results.
Anahtar Kelimeler
Kaynakça
- ecdc.europa.eu/en [homepage on the Internet]. An agency of the European Union [uptodated 18 March 2021; cited 20 March 2021] Available from: https://www.ecdc.europa.eu/en/geographical-distribution-2019-ncov-cases.
- Marosevic D, Belting A, Schönberger K, Carl A, Wenzel JJ, Brey R. Hepatitis A outbreak in the general population due to a MSM-Associated HAV genotype linked to a food handler, november 2017-february 2018, Germany. Food Environ Virol. 2019;11(2):149-156.
- Snyder MR, McGinty MD, Shearer MP, Meyer D, Hurtado C, Nuzzo JB. Outbreaks of Hepatitis A in US Communities, 2017-2018: Firsthand experiences and operational lessons from public health responses. Am J Public Health. 2019;109(S4):297-302.
- coronavirus.jhu.edu [homepage on the Internet]. Johns Hopkins University and Medicine Coronavirus Resource Center. [uptodated 21 March 2021; cited 21 March 2021]. Available from: https://coronavirus.jhu.edu/data/mortality.
- Sarialioglu F, Belen Apak FB, Haberal M. Can Hepatitis A vaccine provide protection against COVID-19? Exp Clin Transplant. 2020;18(2):141-143
- who.int [homepage on the Internet]. World Health Organization. Draft landscape of COVID-19 candidate vaccines. [Cited March 17, 2021]. Available from: https://www.who.int/publications/m/item/draft-landscape-of-covid-19-candidate-vaccines
- ecdc.europa.eu [homepage on the Internet]. An agency of the European Union [cited 20 March 2021]. European Centre for Disease Prevention and Control. Rapid increase of a SARS-CoV-2 variant with multiple spike protein mutations observed in the United Kingdom, December 2020. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/SARS-CoV-2-variant-multiple-spike-protein-mutations-United-Kingdom.pdf (Accessed on March 17, 2021).
- Sarialioğlu F, Belen FB, Hayran KM. Hepatitis A susceptibility parallels high COVID-19 mortality. Turk J Med Sci. 2021;51(1):382-384.
- Clinical management of COVID-19: Interim guidance, 27 May 2020.World Health Organization. Available from:https://apps.who.int/iris/handle/10665/332196.
- Netea MG, Joosten LA, Latz E, Mills KH, Natoli G, Stunnenberg HG et al. Trained immunity: A program of innate immune memory in health and disease. Science. 2016;352(6284):aaf1098.
- Moorlag S, Arts RJ, van Crevel R, Netea MG. Non-specific effects of BCG vaccine on viral infections. Clinical Microbiology and Infection. 2019;25(12):1473-1478.
- Arts RJW, Moorlag S, Novakovic B, Li Y, Wang SY, Oosting M et al. BCG Vaccination protects against experimental viral Infection in humans through the ınduction of cytokines associated 184 with trained ımmunity. Cell Host Microbe. 2018;23(1):89-100.
- Miller A, Reandelar MJ, Fasciglione K, Roumenova V, Li Y, Otazu GH. Correlation between universal BCG vaccination policy and reduced morbidity and mortality for COVID-19: An epidemiological study. MedRxiv. 2020. 173
- Usher NT, Chang S, Howard RS, Martinez A, Harrison LH, Santosham M et al. Association of BCG vaccination in childhood with subsequent cancer diagnoses: A 60-year follow-up of a clinical trial. JAMA Netw Open. 2019;2(9):e1912014.
- Gobe I, Koto GF, Mokomane M, Molebatsi K, Kasvosve I, Motswaledi MS. Vaccination for some childhood diseases may impact the outcome of covid-19 infections. medRxiv 2020.09.02.20186528; doi: https://doi.org/10.1101/2020.09.02.20186528. [Epub ahead of print]. Review.
- Redelman-Sidi G. Could BCG be used to protect against COVID-19? Nature Reviews Urology. 2020;17(6):316-317.
- Surveillance for Respiratory Syncytial Virus in CDC’s Global Disease Detection Network: Epidemiology, Disease Burden and Clinical Characteristics external icon. J Infect Dis. 2013;208(S3):165-246
- Escobar LE, Molina-Cruz A, Barillas-Mury C. BCG vaccine protection from severe coronavirus disease 2019 (COVID-19). Proc Natl Acad Sci U S A. 2020;117(30):17720-17726. Erratum in: Proc Natl Acad Sci U S A. 2020 Nov 3;117(44):27741-27742. PMID: 32647056; PMCID: PMC7395502.
- Hamiel, Uri, Eran Kozer, and Ilan Youngster. 2020. “SARS-CoV-2 Rates in BCG-Vaccinated and Unvaccinated Young Adults. JAMA. 2020 Jun 9;323(22):2340-2341.
- Mosites E, Gounder P, Snowball M, et al. Hepatitis A vaccine immune response 22 years after vaccination. J Med Virol. 2018;90(8):1418-1422.
- Shin EC, Jeong SH. Natural History, Clinical manifestations, and pathogenesis of hepatitis A. Cold Spring Harb Perspect Med. 2018;8(9):a031708.
- Ndumbi P, Freidl GS, Williams CJ, Mårdh O, Varela C, Avellón A et al. Hepatitis A outbreak disproportionately affecting men who have sex with men (MSM) in the European Union and European Economic Area, June 2016 to May 2017. Euro Surveill. 2018;23(33):1700641.
- Bauer D, Farthofer A, Chromy D, Simbrunner B, Steininger L, Schmidbauer C et al. Recent outbreaks of severe hepatitis A virus infections in Vienna. Eur J Clin Microbiol Infect Dis. 2021;40(2):335-344.
- ecdc.europa.eu/en [homepage on the Internet]. An agency of the European Union ‘Epidemiological update: hepatitis A outbreak in the EU/EEA mostly affecting men who have sex with men’, European Centre for Disease Prevention and Control (ECDC) [uptodated 18 March 2018; cited 20.03.2021]. Available from: https://ecdc.europ a.eu/en/news-events/epidemiological-update-hepatitis-outbreak-eueea-mostly-affecting-men-who-have-sex-men-2.
- Tian W, Zhang N, Jin R, Feng Y, Wang S, Gao S et al. Immune suppression in the early stage of COVID-19 disease. Nat Commun. 202
Koronavirüs-19 Enfeksiyonu Olan ve Olmayan Olguların Hepatit A Virüsüne Karşı Kazanılmış İmmün Yanıt Açısından Karşılaştırılması: Retrospektif Bir Çalışma
Öz
Amaç: Bu çalışma ile COVID-19 enfeksiyonu olan ve olmayan olgular arasında Hepatit A virüsüne karşı kazanılmış immün yanıt düzeyi açısından fark
bulunup bulunmadığının irdelenmesi amaçlanmıştır.
Gereç ve Yöntemler: Bu retrospektif, kesitsel, tek merkez çalışmasına kliniğimizde 1 Haziran 2020-1 Eylül 2020 tarihleri arasında COVID-19 hastalığı
(PCR pozitifliği ile doğrulanmış) nedeniyle takip edilmiş 50 olgu dahil edildi. Benzer demografik özelliklere sahip olan, salgın öncesindeki son iki yılda (1
Kasım 2017–1 Kasım 2019) kliniğimize başvuruları sırasında Anti HAV IgG düzeyleri belirlenmiş olgular arasından rastlantısal olarak seçilen toplam 150
olgu ise kontrol grubu olarak alındı. Bu iki grup arasında Anti-HAV IgG seropozitiflik oranları ile serum antikor titreleri karşılaştırıldı.
Bulgular: Çalışmaya dahil edilen toplam 200 olgunun ortanca yaşı 48.5 (IQR=43.0-59.0) yıl olup, 108’i (%54) erkek, 92’si (%46) kadındı. Olguların 142’si
(%71) 60 yaş ve üzerinde idi, ancak hasta grupları içerisindeki 60 yaş ve üzeri olguların oranı benzerdi (p=0.105). COVID-19 olgularındaki Anti-HAV IgG
seropozitifliği oranları kontrol grubundaki olgularla benzer olmakla birlikte (p=0.062), COVID-19 olgularındaki anti HAV IgG titrelerinin, kontrol olgularındakine
göre anlamlı oranda daha düşük olduğu görüldü (p<0.001). Anti-HAV IgG titrelerinin kritik seyirli COVID-19 olgularında (n=7), diğer COVID-19
olgularına (n=43) göre anlamlı oranda daha düşük olduğu görüldü (p=0.049). Buna ek olarak anti-HAV titresi ile kritik COVID-19 hastalığı varlığı arasında
anlamlı ve güçlü düzeyde bir ilişki olduğu (η=0.988) görüldü.
Sonuç: Sonuçlarımız HAV aşısı veya geçirilmiş HAV enfeksiyonu varlığının COVID-19 enfeksiyonunda, özellikle kritik hastalık seyrinin önlenmesi açısından,
koruyucu olabileceğini göstermektedir.
Anahtar Kelimeler
Kaynakça
- ecdc.europa.eu/en [homepage on the Internet]. An agency of the European Union [uptodated 18 March 2021; cited 20 March 2021] Available from: https://www.ecdc.europa.eu/en/geographical-distribution-2019-ncov-cases.
- Marosevic D, Belting A, Schönberger K, Carl A, Wenzel JJ, Brey R. Hepatitis A outbreak in the general population due to a MSM-Associated HAV genotype linked to a food handler, november 2017-february 2018, Germany. Food Environ Virol. 2019;11(2):149-156.
- Snyder MR, McGinty MD, Shearer MP, Meyer D, Hurtado C, Nuzzo JB. Outbreaks of Hepatitis A in US Communities, 2017-2018: Firsthand experiences and operational lessons from public health responses. Am J Public Health. 2019;109(S4):297-302.
- coronavirus.jhu.edu [homepage on the Internet]. Johns Hopkins University and Medicine Coronavirus Resource Center. [uptodated 21 March 2021; cited 21 March 2021]. Available from: https://coronavirus.jhu.edu/data/mortality.
- Sarialioglu F, Belen Apak FB, Haberal M. Can Hepatitis A vaccine provide protection against COVID-19? Exp Clin Transplant. 2020;18(2):141-143
- who.int [homepage on the Internet]. World Health Organization. Draft landscape of COVID-19 candidate vaccines. [Cited March 17, 2021]. Available from: https://www.who.int/publications/m/item/draft-landscape-of-covid-19-candidate-vaccines
- ecdc.europa.eu [homepage on the Internet]. An agency of the European Union [cited 20 March 2021]. European Centre for Disease Prevention and Control. Rapid increase of a SARS-CoV-2 variant with multiple spike protein mutations observed in the United Kingdom, December 2020. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/SARS-CoV-2-variant-multiple-spike-protein-mutations-United-Kingdom.pdf (Accessed on March 17, 2021).
- Sarialioğlu F, Belen FB, Hayran KM. Hepatitis A susceptibility parallels high COVID-19 mortality. Turk J Med Sci. 2021;51(1):382-384.
- Clinical management of COVID-19: Interim guidance, 27 May 2020.World Health Organization. Available from:https://apps.who.int/iris/handle/10665/332196.
- Netea MG, Joosten LA, Latz E, Mills KH, Natoli G, Stunnenberg HG et al. Trained immunity: A program of innate immune memory in health and disease. Science. 2016;352(6284):aaf1098.
- Moorlag S, Arts RJ, van Crevel R, Netea MG. Non-specific effects of BCG vaccine on viral infections. Clinical Microbiology and Infection. 2019;25(12):1473-1478.
- Arts RJW, Moorlag S, Novakovic B, Li Y, Wang SY, Oosting M et al. BCG Vaccination protects against experimental viral Infection in humans through the ınduction of cytokines associated 184 with trained ımmunity. Cell Host Microbe. 2018;23(1):89-100.
- Miller A, Reandelar MJ, Fasciglione K, Roumenova V, Li Y, Otazu GH. Correlation between universal BCG vaccination policy and reduced morbidity and mortality for COVID-19: An epidemiological study. MedRxiv. 2020. 173
- Usher NT, Chang S, Howard RS, Martinez A, Harrison LH, Santosham M et al. Association of BCG vaccination in childhood with subsequent cancer diagnoses: A 60-year follow-up of a clinical trial. JAMA Netw Open. 2019;2(9):e1912014.
- Gobe I, Koto GF, Mokomane M, Molebatsi K, Kasvosve I, Motswaledi MS. Vaccination for some childhood diseases may impact the outcome of covid-19 infections. medRxiv 2020.09.02.20186528; doi: https://doi.org/10.1101/2020.09.02.20186528. [Epub ahead of print]. Review.
- Redelman-Sidi G. Could BCG be used to protect against COVID-19? Nature Reviews Urology. 2020;17(6):316-317.
- Surveillance for Respiratory Syncytial Virus in CDC’s Global Disease Detection Network: Epidemiology, Disease Burden and Clinical Characteristics external icon. J Infect Dis. 2013;208(S3):165-246
- Escobar LE, Molina-Cruz A, Barillas-Mury C. BCG vaccine protection from severe coronavirus disease 2019 (COVID-19). Proc Natl Acad Sci U S A. 2020;117(30):17720-17726. Erratum in: Proc Natl Acad Sci U S A. 2020 Nov 3;117(44):27741-27742. PMID: 32647056; PMCID: PMC7395502.
- Hamiel, Uri, Eran Kozer, and Ilan Youngster. 2020. “SARS-CoV-2 Rates in BCG-Vaccinated and Unvaccinated Young Adults. JAMA. 2020 Jun 9;323(22):2340-2341.
- Mosites E, Gounder P, Snowball M, et al. Hepatitis A vaccine immune response 22 years after vaccination. J Med Virol. 2018;90(8):1418-1422.
- Shin EC, Jeong SH. Natural History, Clinical manifestations, and pathogenesis of hepatitis A. Cold Spring Harb Perspect Med. 2018;8(9):a031708.
- Ndumbi P, Freidl GS, Williams CJ, Mårdh O, Varela C, Avellón A et al. Hepatitis A outbreak disproportionately affecting men who have sex with men (MSM) in the European Union and European Economic Area, June 2016 to May 2017. Euro Surveill. 2018;23(33):1700641.
- Bauer D, Farthofer A, Chromy D, Simbrunner B, Steininger L, Schmidbauer C et al. Recent outbreaks of severe hepatitis A virus infections in Vienna. Eur J Clin Microbiol Infect Dis. 2021;40(2):335-344.
- ecdc.europa.eu/en [homepage on the Internet]. An agency of the European Union ‘Epidemiological update: hepatitis A outbreak in the EU/EEA mostly affecting men who have sex with men’, European Centre for Disease Prevention and Control (ECDC) [uptodated 18 March 2018; cited 20.03.2021]. Available from: https://ecdc.europ a.eu/en/news-events/epidemiological-update-hepatitis-outbreak-eueea-mostly-affecting-men-who-have-sex-men-2.
- Tian W, Zhang N, Jin R, Feng Y, Wang S, Gao S et al. Immune suppression in the early stage of COVID-19 disease. Nat Commun. 202
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Erken Görünüm Tarihi | 10 Temmuz 2023 |
| Yayımlanma Tarihi | 12 Temmuz 2023 |
| Gönderilme Tarihi | 13 Nisan 2022 |
| Kabul Tarihi | 13 Eylül 2022 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 18 Sayı: 2 |
