Table 1.
Clinical Course and Laboratory Results
| Patient ID | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
|---|---|---|---|---|---|---|---|---|---|---|
| Age, years | 27 | 55 | 45 | 55 | 53 | 68 | 55 | 65 | 68 | 73 |
| Sex | F | M | F | M | F | F | F | M | F | F |
| Cirrhosis | Yes | No | No | Yes | Yes | Yes | No | No | No | No |
| Date of previous labs | Feb 17, 2020 | Feb 14, 2020 | Jan 23, 2020 | Mar 9, 2020 | Mar 26, 2019 | Mar 4, 2020 | Feb 1, 2020 | Mar 15, 2020 | Feb 28, 2020 | Feb 20, 2020 |
| AST, U/L | 21 | 37 | 22 | 317 | 34 | N/A | 37 | 19 | 50 | 27 |
| ALT, U/L | 17.4 | 52 | 24 | 497 | 36 | 21 | 19 | 14 | 30 | 16 |
| T Bil, mg/dl | 0.4 | 1.0 | 1.0 | 2.6 | 1.0 | 0.9 | 1.6 | 0.6 | 1.0 | N/A |
| Alb, g/dl | 3.9 | 3.5 | 4.2 | 3.0 | 3.7 | N/A | 4.3 | N/A | N/A | 3.9 |
| PLT, ×103/μL | 146 | 255 | 314 | 124 | 177 | 93 | 159 | N/A | N/A | 215 |
| Lymph, x109/L | N/A | N/A | 2.6 | 2.5 | 2.8 | N/A | N/A | 2.1 | N/A | N/A |
| IgG, g/L | 14.0 | 10.0 | 11.6 | 33.7 | 7.8 | N/A | N/A | N/A | N/A | N/A |
| P pre | Yes | Yes | Yes | Yes | Yes | Yes | Yes | No | Yes | Yes |
| Dose, mg | 10 | 40 | 10 | 60 | 10 | 5 | 5 | 25 | 20 | |
| AZA pre | Yes | Yes | No | No | No | No | Yes | No | No | Yes |
| Dose, mg | 50 | 50 | 100 | 75 | ||||||
| Other drugs for AIH | Tac | No | No | No | No | No | MMF | No | No | |
| Dose | 1 mg every 12 hours | 1,500 mg/day | ||||||||
| Clinical course | ||||||||||
| symptoms onset | Mar 7, 2020 | Mar 6, 2020 | Mar 5, 2020 | Mar 17, 2020 | Mar 1, 2020 | Mar 15, 2020 | Mar 18, 2020 | Mar 11, 2020 | Mar 1, 2020 | Feb 27, 2020 |
| Clinical features | Cough, headache | Fever | Fever, cough | Fever, cough | Cough, fever, diarrhea | Cough, fever | Cough, fever | Fever, cough | Fever, ageusia | Fever, cough |
| Swab positive for SARS‐CoV‐2 | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
| Managed at home or at hospital | Home | Hospital | Hospital | Hospital | Hospital | Hospital | Home | Hospital | Home | Home |
| Pneumonia | N/A | Yes | Yes | Yes | No | Yes | N/A | Yes | N/A | N/A |
| Respiratory failure | No | No | Yes | No | No | Yes | No | Yes | No | No |
| Any change of drugs for AIH | Yes | Yes | No | Yes | Yes | Yes | No | Yes | Yes | No |
| If yes, which drug was changed? | P, Aza | P, Aza | P | P | P | MMF | P | |||
| Dose change | P ↓ 7.5 mg/day, Aza X | P ↓ 30 mg/day, Aza X | P ↓ 40 mg/day | P ↑ | P ↑ 25 mg/day | MMF ↓ 1,000 mg/day | Self‐stopped | |||
| Date of change | Mar 15, 2020 | Mar 7, 2020 | Mar 20, 2020 | Mar 10, 2020 | Mar 26, 2020 | Mar 26, 2020 | Feb 3, 2020 | |||
| Date of return to previous dose | Not yet | Not yet | Not yet | Mar 23, 2020 | Not yet | Not yet | May 16, 2020 † | |||
| Drugs for COVID‐19 | / | H, L/R, Azi | H, L/R | H, D/C | C, L/R | H, L/R | / | H, L/R, Azi | / | / |
| Repeated liver enzymes during COVID‐19 | No* | Yes | Yes | Yes | Yes | Yes | No* | Yes | No* | No* |
| AST, U/L | 39 | 23 | 82 | 98 | 34 | 22 | ||||
| ALT, U/L | 38 | 17 | 101 | 46 | 31 | 11 | ||||
| T Bil, mg/dL | 1.5 | 0.9 | 3.2 | 1.0 | 0.8 | 0.7 | ||||
| Alb, g/dL | 3.5 | 3.6 | 2.6 | 3.4 | N/A | N/A | ||||
| Lymph, x109/L | N/A | 0.7 | 0.6 | 0.3 | N/A | 0.5 | ||||
| Follow‐up labs | Apr 27, 2020 | May 19, 2020 | Mar 20, 2020 | Mar 26, 2020 | Mar 18, 2020 | No | No | Apr 1, 2020 | May 15, 2020 | May 12, 2020 |
| AST, U/L | 25 | 39 | 30 | 66 | 36 | 27 | 600 | 11 | ||
| ALT, U/L | 34 | 39 | 30 | 89 | 27 | 14 | 599 | 17 | ||
| T Bil, mg/dL | 0.6 | 0.7 | N/A | 2.2 | 1 | 0.4 | 2.4 | |||
| Alb, g/dL | 37 | N/A | N/A | 34 | 39 | |||||
| Lymph, x109/L | 1.6 | 3.5 | 1.5 | 3.9 | 1.6 | 1.0 | 1.4 | |||
| Current status (as of May 21, 2020) | A | A | A | A | A | Exitus on Apr 1, 2020 | A | A | A | A |
SI conversion factors: to convert platelet count to ×109 per liter, multiply by 1.
*
Blood exams not repeated due to restrictions related to compulsory quarantine at home.
†
Restarted with Prednisone 50 mg for the treatment of the relapse of AIH.
Abbreviations: A, asymptomatic; ALT, alanine aminotransferase; AST, aspartate aminotransferase; Aza, azathioprine; Azi, azithromycin; C, chloroquine; D/C, darunavir/cobicistat; F, female; H, hydrochloroquine; IgG, Immunoglobulin G; L/R, lopinavir/ritonavir; Lymph, lymphocytes; M, male; MMF, mycophenolate; N/A, not applicable; P, prednisone; PLT, platelets; T Bil, total bilirubin; TAC, tacrolimus; Y, years.