Real-Life Experience in the Efficacy and Safety of COVID-19 Vaccination in Patients with Advanced Cirrhosis.
| Title: | Real-Life Experience in the Efficacy and Safety of COVID-19 Vaccination in Patients with Advanced Cirrhosis. |
|---|---|
| Authors: | Hanafy AS; Internal Medicine Department, Gastroenterology and Hepatology Division, Zagazig University, Zagazig 44519, Egypt.; Embaby A; Clinical Hematology Unit, Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt.; Salem SM; Internal Medicine Department, Gastroenterology and Hepatology Division, Zagazig University, Zagazig 44519, Egypt.; Behiry A; Department of Tropical Medicine and Endemic Diseases, College of Medicine, Zagazig University, Zagazig 44519, Egypt.; Ebrahim HA; Department of Basic Medical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia.; Elkattawy HA; Department of Basic Medical Sciences, College of Medicine, AlMaarefa University, Riyadh 11597, Saudi Arabia.; Medical Physiology Department, College of Medicine, Zagazig University, Zagazig 44519, Egypt.; Abed SY; Department of Respiratory Care, College of Applied Medical Science in Jubail, Imam Abdulrahman Bin Faisal University, Jubail 34212, Saudi Arabia.; Tropical Medicine Department, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt.; Almadani ME; Department of Clinical Medical Sciences, College of Medicine, AlMaarefa University, Riyadh 11597, Saudi Arabia.; El-Sherbiny M; Department of Basic Medical Sciences, College of Medicine, AlMaarefa University, Riyadh 11597, Saudi Arabia. |
| Source: | Journal of clinical medicine [J Clin Med] 2023 Dec 08; Vol. 12 (24). Date of Electronic Publication: 2023 Dec 08. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: MDPI AG Country of Publication: Switzerland NLM ID: 101606588 Publication Model: Electronic Cited Medium: Print ISSN: 2077-0383 (Print) Linking ISSN: 20770383 NLM ISO Abbreviation: J Clin Med Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: Basel, Switzerland : MDPI AG, [2012]- |
| Abstract: | COVID-19 infections accelerate liver decompensation and serious liver-related co-morbidities. The aim is to evaluate the safety and impact of COVID vaccines on hepatic disease progression in patients with advanced liver disease and to identify parameters that predict the occurrence of complications. The study involved 70 patients with advanced liver disease who were vaccinated with different COVID vaccines from January 2021 to April 2022. They were evaluated clinically. The laboratory investigation included a complete blood count, liver and kidney function tests, calculation of CTP and MELD scores, plasma levels of ammonia, abdominal ultrasound, and upper GI endoscopy. Twenty patients had experienced complications 64 ± 12 days from the last dose of a vaccination. Twenty patients (28.6%) developed hepatic decompensation and hypothyroidism (n = 11, 15.7%), and five (7.14%) patients developed splanchnic thrombosis. There were no COVID-19 reinfections except for two patients who received Sinopharm and developed vaccine-associated enhanced disease (2.9%). Complications after COVID vaccinations were correlated with ALT (r = 0.279, p = 0.019), serum sodium (r = -0.30, p = 0.005), creatinine (r = 0.303, p = 0.011), liver volume (LV) (r = -0.640, p = 0.000), and MELD score (r = 0.439, p = 0.000). Multivariate logistic regression revealed that LV is the only independent predictor (p = 0.001). LV ≤ 682.3 has a sensitivity of 95.24% and a specificity of 85.71% in predicting complications with an AUC of 0.935, p < 0.001. In conclusion, the hepatic reserve and prognosis in liver cirrhosis should be evaluated prior to COVID vaccinations using the MELD score and liver volume as promising risk stratification criteria. In summary, the research proposes a novel triaging strategy that involves utilizing the MELD score and liver volume as risk stratification parameters of the hepatic reserve and prognosis of advanced liver cirrhosis prior to COVID immunization to determine who should not receive a COVID vaccination. |
| References: | Lancet Gastroenterol Hepatol. 2020 May;5(5):428-430. (PMID: 32145190); J Clin Exp Hepatol. 2022 Jan-Feb;12(1):186-199. (PMID: 35068798); J Immunol. 2018 Feb 1;200(3):937-948. (PMID: 29282308); Liver Int. 2018 Feb;38 Suppl 1:126-133. (PMID: 29427501); Intensive Care Med. 2020 Apr;46(4):586-590. (PMID: 32125455); Emerg Microbes Infect. 2020 Dec;9(1):707-713. (PMID: 32208917); J Endocrinol Invest. 2022 Dec;45(12):2283-2289. (PMID: 35829989); Lancet. 2020 Sep 26;396(10255):887-897. (PMID: 32896291); Int J Biol Macromol. 2020 Nov 1;162:820-837. (PMID: 32599237); N Engl J Med. 2021 Feb 18;384(7):643-649. (PMID: 33378605); Hepatology. 2021 Aug;74(2):1049-1064. (PMID: 33577086); JHEP Rep. 2020 Oct;2(5):100169. (PMID: 32835190); Lancet Respir Med. 2020 May;8(5):475-481. (PMID: 32105632); Circulation. 2022 Sep 6;146(10):743-754. (PMID: 35993236); JAMA. 2020 Sep 8;324(10):951-960. (PMID: 32789505); Lancet. 2021 Jan 9;397(10269):99-111. (PMID: 33306989); Curr Gene Ther. 2013 Dec;13(6):421-33. (PMID: 24279313); N Engl J Med. 2021 Jun 10;384(23):2187-2201. (PMID: 33882225); Hepatology. 2010 Jul;52(1):249-55. (PMID: 20578143); Vaccine. 2021 May 21;39(22):3053-3066. (PMID: 33637387); JAMA. 2020 Mar 17;323(11):1061-1069. (PMID: 32031570); N Engl J Med. 2020 Nov 12;383(20):1920-1931. (PMID: 32663912); Front Immunol. 2022 Apr 04;13:882972. (PMID: 35444667); Lancet Gastroenterol Hepatol. 2020 Jun;5(6):529-530. (PMID: 32203680); Ann Pharmacother. 2013 Mar;47(3):333-9. (PMID: 23482730); J Hepatol. 2019 Jun;70(6):1222-1261. (PMID: 30926241); Viruses. 2012 Jun;4(6):1011-33. (PMID: 22816037); Infect Dis Poverty. 2022 May 16;11(1):56. (PMID: 35578350); Ann Neurol. 2021 Oct;90(4):627-639. (PMID: 34288044); J Clin Exp Hepatol. 2021 Nov-Dec;11(6):713-719. (PMID: 33994708); Front Immunol. 2021 Jan 19;11:617089. (PMID: 33584709); Lancet. 2020 Jun 13;395(10240):1845-1854. (PMID: 32450106); J Thromb Thrombolysis. 2023 Jan;55(1):18-31. (PMID: 36402911); Cell Rep Med. 2023 Jun 20;4(6):101084. (PMID: 37315558); MMWR Morb Mortal Wkly Rep. 2021 Nov 12;70(45):1579-1583. (PMID: 34758012); J Endocrinol Invest. 2022 Oct;45(10):1835-1863. (PMID: 35347651); J Hepatol. 2021 Apr;74(4):944-951. (PMID: 33563499); Pharmaceutics. 2020 Jan 28;12(2):. (PMID: 32013049); J Immunother Cancer. 2018 May 22;6(1):40. (PMID: 29789020); J Clin Med. 2021 Sep 02;10(17):. (PMID: 34501430); N Engl J Med. 2020 Dec 31;383(27):2603-2615. (PMID: 33301246); Liver Int. 2020 Jun;40(6):1316-1320. (PMID: 32329563); J Clin Med. 2023 Oct 14;12(20):. (PMID: 37892655); Front Immunol. 2023 Apr 06;14:1129746. (PMID: 37090700) |
| Contributed Indexing: | Keywords: COVID-19; MELD; complications; liver cirrhosis; liver volume; vaccines |
| Entry Date(s): | Date Created: 20231223 Latest Revision: 20231225 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC10744263 |
| DOI: | 10.3390/jcm12247578 |
| PMID: | 38137646 |
| Database: | MEDLINE |
Journal Article