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

tetano

Editor, Senior Moderator
Clin Mol Hepatol


. 2022 Oct;28(4):890-911.
doi: 10.3350/cmh.2022.0087. Epub 2022 Jun 3.
COVID-19 vaccine immunogenicity among chronic liver disease patients and liver transplant recipients: A meta-analysis


Ka Shing Cheung[SUP] 1 2 [/SUP], Chiu Hang Mok[SUP] 3 [/SUP], Xianhua Mao[SUP] 1 [/SUP], Ruiqi Zhang[SUP] 1 [/SUP], Ivan Fn Hung[SUP] 1 [/SUP], Wai Kay Seto[SUP] 1 2 4 [/SUP], Man Fung Yuen[SUP] 1 4 [/SUP]



Affiliations

Abstract

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

Keywords: COVID-19; Chronic hepatitis B; Liver transplant; Non-alcoholic fatty liver disease; SARS-CoV-2.
 
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