tetano
Editor, Senior Moderator
Hepatol Commun
. 2021 Oct 28.
doi: 10.1002/hep4.1853. Online ahead of print.
SARS-CoV-2 infections among patients with liver disease and liver transplantation who received COVID-19 vaccination
Andrew M Moon[SUP] 1 [/SUP], Gwilym J Webb[SUP] 2 [/SUP], Ignacio García-Juárez[SUP] 3 [/SUP], Anand V Kulkarni[SUP] 4 [/SUP], Gupse Adali[SUP] 5 [/SUP], David K Wong[SUP] 6 [/SUP], Beth Lusina[SUP] 7 [/SUP], George N Dalekos[SUP] 8 [/SUP], Steven Masson[SUP] 9 [/SUP], Brandon M Shore[SUP] 10 [/SUP], Eleanor Barnes[SUP] 11 [/SUP], A Sidney Barritt 4th[SUP] 1 [/SUP], Thomas Marjot[SUP] 11 [/SUP]
Affiliations
Abstract
Background and aims: Many safe and effective severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccinations dramatically reduce risks of coronavirus disease-2019 (COVID-19) complications and deaths. We aimed to describe cases of SARS-CoV-2 infection among chronic liver disease (CLD) patients and liver transplant (LT) recipients with at least one prior COVID-19 vaccine dose.
Approach and results: The SECURE-Liver and COVID-Hep international reporting registries were used to identify laboratory-confirmed COVID-19 in CLD and LT patients who received a COVID-19 vaccination. Of 342 cases of lab-confirmed SARS-CoV-2 infections in the era after vaccine licensing, 40 patients (21 with CLD and 19 with LT) had at least one prior COVID-19 vaccination, including 12 who were fully vaccinated (≥2 weeks after second dose). Of the 21 patients with CLD (90% with cirrhosis), 7 (33%) were hospitalized, 1 (5%) admitted to the ICU, and 0 died. In the LT cohort (n=19), there were 6 hospitalizations (32%), including 3 (16%) resulting in mechanical ventilation and 2 (11%) resulting in death. All three cases of severe COVID-19 occurred in patients who had a single vaccine dose within the last 1-2 weeks. In contemporary CLD patients, rates of symptomatic infection, hospitalization, ICU admission, invasive ventilation and death were numerically higher in unvaccinated individuals.
Conclusions: This case series demonstrates the potential for COVID-19 infections among patients with CLD and LT recipients who had received COVID-19 vaccination. Vaccination against SARS-CoV-2 seems to result in favorable outcomes as attested by the absence of mechanical ventilation, ICU or death among fully vaccinated patients.
Keywords: COVID-Hep; SECURE-Liver; cirrhosis; coronavirus; immunization; liver transplantation.
. 2021 Oct 28.
doi: 10.1002/hep4.1853. Online ahead of print.
SARS-CoV-2 infections among patients with liver disease and liver transplantation who received COVID-19 vaccination
Andrew M Moon[SUP] 1 [/SUP], Gwilym J Webb[SUP] 2 [/SUP], Ignacio García-Juárez[SUP] 3 [/SUP], Anand V Kulkarni[SUP] 4 [/SUP], Gupse Adali[SUP] 5 [/SUP], David K Wong[SUP] 6 [/SUP], Beth Lusina[SUP] 7 [/SUP], George N Dalekos[SUP] 8 [/SUP], Steven Masson[SUP] 9 [/SUP], Brandon M Shore[SUP] 10 [/SUP], Eleanor Barnes[SUP] 11 [/SUP], A Sidney Barritt 4th[SUP] 1 [/SUP], Thomas Marjot[SUP] 11 [/SUP]
Affiliations
- PMID: 34708575
- DOI: 10.1002/hep4.1853
Abstract
Background and aims: Many safe and effective severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccinations dramatically reduce risks of coronavirus disease-2019 (COVID-19) complications and deaths. We aimed to describe cases of SARS-CoV-2 infection among chronic liver disease (CLD) patients and liver transplant (LT) recipients with at least one prior COVID-19 vaccine dose.
Approach and results: The SECURE-Liver and COVID-Hep international reporting registries were used to identify laboratory-confirmed COVID-19 in CLD and LT patients who received a COVID-19 vaccination. Of 342 cases of lab-confirmed SARS-CoV-2 infections in the era after vaccine licensing, 40 patients (21 with CLD and 19 with LT) had at least one prior COVID-19 vaccination, including 12 who were fully vaccinated (≥2 weeks after second dose). Of the 21 patients with CLD (90% with cirrhosis), 7 (33%) were hospitalized, 1 (5%) admitted to the ICU, and 0 died. In the LT cohort (n=19), there were 6 hospitalizations (32%), including 3 (16%) resulting in mechanical ventilation and 2 (11%) resulting in death. All three cases of severe COVID-19 occurred in patients who had a single vaccine dose within the last 1-2 weeks. In contemporary CLD patients, rates of symptomatic infection, hospitalization, ICU admission, invasive ventilation and death were numerically higher in unvaccinated individuals.
Conclusions: This case series demonstrates the potential for COVID-19 infections among patients with CLD and LT recipients who had received COVID-19 vaccination. Vaccination against SARS-CoV-2 seems to result in favorable outcomes as attested by the absence of mechanical ventilation, ICU or death among fully vaccinated patients.
Keywords: COVID-Hep; SECURE-Liver; cirrhosis; coronavirus; immunization; liver transplantation.