Department of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Liver Int. 2023 Jan;43(1):34-48. doi: 10.1111/liv.15403. Epub 2022 Sep 14.
Chronic liver disease (CLD) patients and liver transplant (LT) recipients have an increased risk of morbidity and mortality from coronavirus disease 2019 (COVID-19). The immunogenicity of COVID-19 vaccines in CLD patients and LT recipients is poorly understood. The present study aimed to evaluate the immunogenicity of COVID-19 vaccines in CLD patients and LT recipients.
We searched electronic databases for eligible studies. Two reviewers independently conducted the literature search, extracted the data and assessed the risk of bias of included studies. The rates of detectable immune response were pooled from single-arm studies. For comparative studies, we compared the rates of detectable immune response between patients and healthy controls. The meta-analysis was conducted using the Stata software with a random-effects model.
In total, 19 observational studies involving 4191 participants met the inclusion criteria. The pooled rates of detectable humoral immune response after two doses of COVID-19 vaccination in CLD patients and LT recipients were 95% (95% confidence interval [CI] = 88%-99%) and 66% (95% CI = 57%-74%) respectively. After two doses of vaccination, the humoral immune response rate was similar in CLD patients and healthy controls (risk ratio [RR] = 0.96; 95% CI = 0.90-1.02; p = .14). In contrast, LT recipients had a lower humoral immune response rate after two doses of vaccination than healthy controls (RR = 0.68; 95% CI = 0.59-0.77; p < .01).
Our meta-analysis demonstrated that COVID-19 vaccination induced strong humoral immune responses in CLD patients but poor humoral immune responses in LT recipients.
慢性肝病（CLD）患者和肝移植（LT）受者罹患 2019 冠状病毒病（COVID-19）的发病率和死亡率较高。COVID-19 疫苗在 CLD 患者和 LT 受者中的免疫原性尚未充分阐明。本研究旨在评估 COVID-19 疫苗在 CLD 患者和 LT 受者中的免疫原性。
我们检索电子数据库以获取合格研究。两名评审员独立进行文献检索、提取数据并评估纳入研究的偏倚风险。从单臂研究中汇总可检测免疫应答率。对于比较性研究，我们比较了患者和健康对照者之间可检测免疫应答率。采用 Stata 软件进行荟萃分析，使用随机效应模型。
共纳入 19 项包含 4191 名参与者的观察性研究。CLD 患者和 LT 受者接受两剂 COVID-19 疫苗接种后可检测到的体液免疫应答率分别为 95%（95%置信区间[CI] = 88%-99%）和 66%（95% CI = 57%-74%）。接种两剂疫苗后，CLD 患者和健康对照者的体液免疫应答率相似（风险比[RR] = 0.96；95% CI = 0.90-1.02；p =.14）。相比之下，LT 受者接种两剂疫苗后的体液免疫应答率低于健康对照者（RR = 0.68；95% CI = 0.59-0.77；p < 0.01）。
我们的荟萃分析表明，COVID-19 疫苗在 CLD 患者中诱导了强烈的体液免疫应答，但在 LT 受者中诱导了较弱的体液免疫应答。
