Tang R.S.Y.Sattayalertyanyong O.Kuo Y.T.Park K.H.Anastassiades C.Ligresti D.Hayashi N.Hasan A.Kim T.H.Pausawasdi N.Wang H.P.Lo S.K.Ho K.Y.Barresi L.Traina M.Yasuda I.Savides T.J.Koo C.S.Chan T.T.Lam T.Y.T.Sung J.J.Y.Mahidol University2023-05-192023-05-192023-04-01Journal of Gastroenterology and Hepatology (Australia) Vol.38 No.4 (2023) , 584-58908159319https://repository.li.mahidol.ac.th/handle/20.500.14594/82344Background and Aim: Dedicated studies evaluating the impact of COVID-19 on outcomes of pancreatobiliary IgG4 related disease (IgG4-RD) patients are scarce. Whether COVID-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 of COVID-19 infection, IgG4-RD disease activity and treatment status, interruption of indicated IgG4-RD treatment. Prospective data on COVID-19 vaccination status and new COVID-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. In 2020 (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 towards higher COVID-19 infection rate was noted in the non-fully vaccinated/unvaccinated group (17.6% vs 33.3%, P = 0.376). No IgG4-RD exacerbation following COVID-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. No IgG4-RD exacerbation after COVID-19 infection or vaccination was observed.MedicineArticleSCOPUS10.1111/jgh.161002-s2.0-851460958311440174636582040