Impact of COVID-19 on the liver and on the care of patients with chronic liver disease, hepatobiliary cancer, and liver transplantation: An updated EASL position paper

Journal of Hepatology, Год журнала: 2022, Номер 77(4), С. 1161 - 1197

Опубликована: Июль 20, 2022

Язык: Английский

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Effectiveness of inactivated COVID-19 vaccines among older adults in Shanghai: retrospective cohort study

Nature Communications, Год журнала: 2023, Номер 14(1)

Опубликована: Апрель 10, 2023

Abstract We conducted a matched retrospective cohort study of two cohorts to estimate inactivated vaccine effectiveness (VE) and its comparative booster dose among older people in Shanghai. Cohort 1 consisted vaccinated group (≥1 dose) an unvaccinated (3,317,475 pairs), 2 fully (2,084,721 pairs). The Kaplan–Meier method Cox regression models were used risk hazard ratios (HRs) outcomes. For 1, the overall estimated VEs ≥1 against SARS-CoV-2 infection, severe/critical Covid-19, Covid-19 related death 24.7% (95%CI 23.7%−25.7%), 86.6% (83.1%−89.4%), 93.2% (88.0%−96.1%), respectively. Subset analysis showed that vaccination provided greatest protection. 2, compared with full vaccination, relative corresponding outcome 16.3% (14.4%−17.9%), 60.5% (37.8%−74.9%), 81.7% (17.5%−95.9%). Here we show, although under scenario persistent dynamic zero-Covid policy non-pharmaceutical interventions, promoting high uptake series adults is critically important. Timely effective protection

Язык: Английский

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COVID-19 vaccine immunogenicity among chronic liver disease patients and liver transplant recipients: A meta-analysis

Clinical and Molecular Hepatology, Год журнала: 2022, Номер 28(4), С. 890 - 911

Опубликована: Июнь 3, 2022

Data of coronavirus disease 2019 (COVID-19) vaccine immunogenicity among chronic liver (CLD) and transplant (LT) patients are conflicting. We performed meta-analysis to examine regarding etiology, cirrhosis status, platform type antibody.We collected data via three databases from inception February 16, 2022, reported pooled seroconversion rate, T cell response safety after two doses.Twenty-eight (CLD only: 5; LT 18; both: 2; with third dose: 3) observational studies 3,945 were included. For CLD patients, rate ranged between 84% (95% confidence interval [CI], 76-90%) 91% CI, 83-95%), based predominantly on neutralizing antibody anti-spike antibody, respectively. Seroconversion was 81% 76-86%) in hepatitis B, 96% 93-97%) non-alcoholic fatty disease, 85% 75-91%) 78-90%) non-cirrhosis, 86% 78-92%) for inactivated 89% 71-96%) mRNA vaccine. The 66% 55-75%) doses vaccines 88% 58-98%) dose recipients. 65% 30-89%). Prevalence adverse events 27% 18-38%) 63% 39-82%) groups, respectively.CLD had good humoral COVID-19 vaccine, while recipients lower response.

Язык: Английский

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Vaccination in liver diseases and liver transplantation: Recommendations, implications and opportunities in the post-COVID era

JHEP Reports, Год журнала: 2023, Номер 5(8), С. 100776 - 100776

Опубликована: Апрель 26, 2023

The interest in vaccination efficacy and toxicity has surged following the COVID-19 pandemic. Immune responses to several vaccines have been shown be suboptimal patients with chronic liver disease (CLD) transplant (LT) recipients, as a consequence of cirrhosis-associated immune dysfunction or post-LT immunosuppression, respectively. Accordingly, vaccine-preventable infections may more common severe those than general population. pandemic greatly accelerated research development into technology platforms, which will spillover benefits for disease. aims this review are: (i) discuss impact on CLD LT (ii) appraise current evidence supporting strategies, (iii) provide some insight recent developments relevant

Язык: Английский

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Cirrhosis is associated with lower serological responses to COVID-19 vaccines in patients with chronic liver disease

JHEP Reports, Год журнала: 2023, Номер 5(5), С. 100697 - 100697

Опубликована: Фев. 20, 2023

•Two-dose vaccines increase Wuhan-Hu-1 IgG, IgM, and neutralisation levels in patients with CLD.•Cirrhosis, older age, type of vaccine predict lower IgG titres.•Compared Wuhan-Hu-1, humoral immunity was for the B.1.617 B.1.1.529 variants, all decreased after 6 months.•No major clinical or immune parameters associated SARS-CoV-2 infection rates efficacy. Background & AimsThe response chronic liver disease (CLD) to COVID-19 remains unclear. Our aim assess efficacy two-dose among CLD different aetiologies stages.MethodsA total 357 were recruited centres from six European countries, 132 healthy volunteers served as controls. Serum (nM), IgM neutralising antibodies (%) against B.1.617, spike proteins determined before vaccination (T0) 14 days (T2) months (T3) second-dose vaccination. Patients fulfilling inclusion criteria at T2 (n = 212) stratified into 'low' 'high' responders according levels. Infection severity collected throughout study.ResultsWuhan-Hu-1 significantly increased T0 vaccinated BNT162b2 (70.3%), mRNA-1273 (18.9%), ChAdOx1 (10.8%). In multivariate analysis, cirrhosis, (ChAdOx1 > mRNA-1273) predicted response, whereas viral hepatitis antiviral therapy response. Compared and, further, both T3. individuals, presented IgGs no additional key differences. No efficacy.ConclusionsPatients cirrhosis exhibit responses vaccination, irrespective aetiology. The leads antibody that appear not associate distinct efficacy, although this needs validation larger cohorts a more balanced representation vaccines.Impact ImplicationsIn vaccines, (Vaxzevria Pfizer BioNTech Moderna) 'lower' aetiology prior 'higher' This differential appears incidence However, compared Delta Omicron months. As such, CLD, particularly those should be prioritised receiving booster doses and/or recently approved adapted vaccines. stages. A study.

Язык: Английский

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Immunogenicity of COVID‐19 vaccines in chronic liver disease patients and liver transplant recipients: A systematic review and meta‐analysis

Liver International, Год журнала: 2022, Номер 43(1), С. 34 - 48

Опубликована: Авг. 20, 2022

Chronic liver disease (CLD) patients and transplant (LT) recipients have an increased risk of morbidity mortality from coronavirus 2019 (COVID-19). The immunogenicity COVID-19 vaccines in CLD LT is poorly understood. present study aimed to evaluate the recipients.We searched electronic databases for eligible studies. Two reviewers independently conducted literature search, extracted data assessed bias included rates detectable immune response were pooled single-arm For comparative studies, we compared between healthy controls. meta-analysis was using Stata software with a random-effects model.In total, 19 observational studies involving 4191 participants met inclusion criteria. humoral after two doses vaccination 95% (95% confidence interval [CI] = 88%-99%) 66% CI 57%-74%) respectively. After vaccination, rate similar controls (risk ratio [RR] 0.96; 0.90-1.02; p .14). In contrast, had lower than (RR 0.68; 0.59-0.77; < .01).Our demonstrated that induced strong responses but poor recipients.

Язык: Английский

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COVID-19 Vaccination in Patients with Chronic Liver Disease

Viruses, Год журнала: 2022, Номер 14(12), С. 2778 - 2778

Опубликована: Дек. 13, 2022

Vaccination against SARS-CoV-2 has become a central public health issue, primarily for vulnerable populations such as individuals with Chronic Liver Disease (CLD). Increased COVID-19-related mortality and disease severity been noted in this subgroup of patients. Severe COVID-19 tends to further deregulate liver function patients chronic failure or cirrhosis even reactivate hepatitis people living HBV HCV. In addition, impaired hepatic leads several limitations possible therapeutic interventions. dysregulation, along the underlying cirrhosis-associated immune dysfunction (CAID), decreased response vaccination that, turn, may result reduced efficacy rates lowered lasting protection. According current guidelines, timely frequent booster shot administration are deemed necessary context. Vaccination-related adverse events mostly mild nature similar those reported general population, whereas incidence injury following is relatively rare. We aimed review available evidence recommendations associated disease, provide insight issues future directions.

Язык: Английский

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Association between Recent Usage of Antibiotics and Immunogenicity within Six Months after COVID-19 Vaccination

Vaccines, Год журнала: 2022, Номер 10(7), С. 1122 - 1122

Опубликована: Июль 14, 2022

Background: Gut microbiota can be associated with COVID-19 vaccine immunogenicity. We investigated whether recent antibiotic use influences BNT162b2 Methods: recipients from three centers were prospectively recruited. Outcomes of interest seroconversion neutralising antibody (NAb) at day 21, 56 and 180 after first dose. calculated the adjusted odds ratio (aOR) usage (defined as ever any antibiotics within six months before dose vaccine) by adjusting for covariates including age, sex, smoking, alcohol, comorbidities. Results: Of 316 (100 [31.6%] male; median age: 50.1 [IQR: 40.0-57.0] years) recruited, 29 (9.2%) users. There was a trend lower rates in users than non-users 21 (82.8% vs. 91.3%; p = 0.14) (96.6% 99.3%; 0.15), but not (93.3% 94.1%). A multivariate analysis showed that rate (aOR 0.26;95% CI: 0.08-0.96). Other factors included age ≥ 60 years (aOR: 0.34;95% 0.13-0.95) male sex 0.14, 95% 0.05-0.34). no significant two doses BNT16b2, 0.03;95% 0.001-1.15). Conclusions: Recent may (but or 180) among recipients. Further long-term follow-up data larger sample size is needed to reach definite conclusion on how influence immunogenicity durability response.

Язык: Английский

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COVID-19 vaccines in patients with decompensated cirrhosis: a retrospective cohort on safety data and risk factors associated with unvaccinated status

Infectious Diseases of Poverty, Год журнала: 2022, Номер 11(1)

Опубликована: Май 16, 2022

Safety data reported from the large-scale clinical trials of coronavirus disease 2019 (COVID-19) vaccine are extremely limited in patients with decompensated cirrhosis. The vaccination campaign this specific population could be difficult due to uncertainty about adverse events following vaccination. We aimed assessed COVID-19 rate, factors associated unvaccinated status, and cirrhosis.This is a retrospective study Ruijin Hospial (Shanghai, China) on an ongoing prospective cohort designed for long-term survival analysis cirrhotic who recovered decompensating or acute-on-chronic liver failure (ACLF) between 2016 2018. number doses, type vaccine, safety data, patient-reported reasons remaining unvaccinated, vaccine. Binary logistic regression was used identifying status.A total 229 cirrhosis without previous SARS-CoV-2 infection participated (mean age, 56 ± 12.2 years, 75% male, 65% viral-related cirrhosis). Mode decompensation were grade II‒III ascites (82.5%), gastroesophageal varices bleeding (7.9%), hepatic encephalopathy (7.9%). Eighty-five participants (37.1%) received at least one dose (1 dose: n = 1, 2 doses: 65, 3 19) while 62.9% remained unvaccinated. Patient-reported mainly fear (37.5%) lack positive advice healthcare providers (52.1%). experience (OR 5.61, 95% CI: 1.24-25.4) ACLF 3.13, 1.12-8.69) post-liver transplantation status 2.47, 1.06-5.76) risk independent residential areas. demonstrated that 75.3% had no events, 23.6% non-severe reactions (20% injection-site pain, 1.2% fatigue, 2.4% rash) severe event (development acute requiring hospitalization).Patients eastern China largely particularly those episodes recipients. Vaccination against safe.

Язык: Английский

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Breakthrough SARS‐CoV‐2 infection outcomes in vaccinated patients with chronic liver disease and cirrhosis: A National COVID Cohort Collaborative study

Hepatology, Год журнала: 2022, Номер 77(3), С. 834 - 850

Опубликована: Сен. 10, 2022

Background and Aims: Outcomes of breakthrough SARS‐CoV‐2 infections have not been well characterized in non‐veteran vaccinated patients with chronic liver diseases (CLD). We used the National COVID Cohort Collaborative (N3C) to describe these outcomes. Approach Results: identified all CLD or without cirrhosis who had testing N3C Data Enclave as January 15, 2022. Poisson regression estimate incidence rates Cox survival analyses associate vaccination status all‐cause mortality at 30 days among infected patients. isolated 278,457 total patients: 43,079 (15%) 235,378 (85%) unvaccinated. Of patients, 32,838 (76%) were 10,441 (24%) cirrhosis. Breakthrough infection incidences 5.4 4.9 per 1000 person‐months for fully cirrhosis, respectively. 68,048 unvaccinated 15% 3.7%, respectively, developed infection. The 30‐day outcome mechanical ventilation death after 15.2% 7.7%, Compared full was associated a 0.34‐times adjusted hazard days. Conclusions: In this study, similar Full 66% reduction risk These results provide an additional impetus increasing uptake populations.

Язык: Английский

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