TY - JOUR
T1 - Serological response and breakthrough infection after COVID-19 vaccination in patients with cirrhosis and post-liver transplant
AU - the COBALT Consortium
AU - Mehta, Gautam
AU - Riva, Antonio
AU - Ballester, Maria Pilar
AU - Uson, Eva
AU - Pujadas, Montserrat
AU - Carvalho-Gomes, Ângela
AU - Sahuco, Ivan
AU - Bono, Ariadna
AU - D'Amico, Federico
AU - Viganò, Raffaela
AU - Diago, Elena
AU - Lanseros, Beatriz Tormo
AU - Inglese, Elvira
AU - Vazquez, Dani Martinez
AU - Sharma, Rajni
AU - Tsou, Hio Lam Phoebe
AU - Harris, Nicola
AU - Broekhoven, Annelotte
AU - Kikkert, Marjolein
AU - Torres Morales, Shessy P.
AU - Myeni, Sebenzile K.
AU - Riveiro-Barciela, Mar
AU - Palom, Adriana
AU - Zeni, Nicola
AU - Brocca, Alessandra
AU - Cussigh, Annarosa
AU - Cmet, Sara
AU - Escudero-García, Desamparados
AU - Stocco, Matteo
AU - Natola, Leonardo Antonio
AU - Ieluzzi, Donatella
AU - Paon, Veronica
AU - Sangiovanni, Angelo
AU - Farina, Elisa
AU - di Benedetto, Clara
AU - Sánchez-Torrijos, Yolanda
AU - Lucena-Varela, Ana
AU - Román, Eva
AU - Sánchez, Elisabet
AU - Sánchez-Aldehuelo, Rubén
AU - López-Cardona, Julia
AU - Canas-Perez, Itzel
AU - Eastgate, Christine
AU - Jeyanesan, Dhaarica
AU - Morocho, Alejandro Esquivel
AU - Di Cola, Simone
AU - Lapenna, Lucia
AU - Zaccherini, Giacomo
AU - Bongiovanni, Deborah
AU - Chokshi, Shilpa
N1 - Publisher Copyright:
Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Association for the Study of Liver Diseases.
PY - 2023/11
Y1 - 2023/11
N2 - Background: Vaccine hesitancy and lack of access remain major issues in disseminating COVID-19 vaccination to liver patients globally. Factors predicting poor response to vaccination and risk of breakthrough infection are important data to target booster vaccine programs. The primary aim of the current study was to measure humoral responses to 2 doses of COVID-19 vaccine. Secondary aims included the determination of factors predicting breakthrough infection. Methods: COVID-19 vaccination and Biomarkers in cirrhosis And post-Liver Transplantation is a prospective, multicenter, observational case-control study. Participants were recruited at 4-10 weeks following first and second vaccine doses in cirrhosis [n = 325; 94% messenger RNA (mRNA) and 6% viral vaccine], autoimmune liver disease (AILD) (n = 120; 77% mRNA and 23% viral vaccine), post-liver transplant (LT) (n = 146; 96% mRNA and 3% viral vaccine), and healthy controls (n = 51; 72% mRNA, 24% viral and 4% heterologous combination). Serological end points were measured, and data regarding breakthrough SARS-CoV-2 infection were collected. Results: After adjusting by age, sex, and time of sample collection, anti-Spike IgG levels were the lowest in post-LT patients compared to cirrhosis (p < 0.0001), AILD (p < 0.0001), and control (p = 0.002). Factors predicting reduced responses included older age, Child-Turcotte-Pugh B/C, and elevated IL-6 in cirrhosis; non-mRNA vaccine in AILD; and coronary artery disease, use of mycophenolate and dysregulated B-call activating factor, and lymphotoxin-α levels in LT. Incident infection occurred in 6.6%, 10.6%, 7.4%, and 15.6% of cirrhosis, AILD, post-LT, and control, respectively. The only independent factor predicting infection in cirrhosis was low albumin level. Conclusions: LT patients present the lowest response to the SARS-CoV-2 vaccine. In cirrhosis, the reduced response is associated with older age, stage of liver disease and systemic inflammation, and breakthrough infection with low albumin level.
AB - Background: Vaccine hesitancy and lack of access remain major issues in disseminating COVID-19 vaccination to liver patients globally. Factors predicting poor response to vaccination and risk of breakthrough infection are important data to target booster vaccine programs. The primary aim of the current study was to measure humoral responses to 2 doses of COVID-19 vaccine. Secondary aims included the determination of factors predicting breakthrough infection. Methods: COVID-19 vaccination and Biomarkers in cirrhosis And post-Liver Transplantation is a prospective, multicenter, observational case-control study. Participants were recruited at 4-10 weeks following first and second vaccine doses in cirrhosis [n = 325; 94% messenger RNA (mRNA) and 6% viral vaccine], autoimmune liver disease (AILD) (n = 120; 77% mRNA and 23% viral vaccine), post-liver transplant (LT) (n = 146; 96% mRNA and 3% viral vaccine), and healthy controls (n = 51; 72% mRNA, 24% viral and 4% heterologous combination). Serological end points were measured, and data regarding breakthrough SARS-CoV-2 infection were collected. Results: After adjusting by age, sex, and time of sample collection, anti-Spike IgG levels were the lowest in post-LT patients compared to cirrhosis (p < 0.0001), AILD (p < 0.0001), and control (p = 0.002). Factors predicting reduced responses included older age, Child-Turcotte-Pugh B/C, and elevated IL-6 in cirrhosis; non-mRNA vaccine in AILD; and coronary artery disease, use of mycophenolate and dysregulated B-call activating factor, and lymphotoxin-α levels in LT. Incident infection occurred in 6.6%, 10.6%, 7.4%, and 15.6% of cirrhosis, AILD, post-LT, and control, respectively. The only independent factor predicting infection in cirrhosis was low albumin level. Conclusions: LT patients present the lowest response to the SARS-CoV-2 vaccine. In cirrhosis, the reduced response is associated with older age, stage of liver disease and systemic inflammation, and breakthrough infection with low albumin level.
UR - https://www.scopus.com/pages/publications/85188182900
U2 - 10.1097/HC9.0000000000000273
DO - 10.1097/HC9.0000000000000273
M3 - Article
C2 - 37870985
AN - SCOPUS:85188182900
SN - 2471-254X
VL - 7
SP - e0273
JO - Hepatology Communications
JF - Hepatology Communications
IS - 11
ER -
SDG 3 Good Health and Well-being