COVID-19 疫苗接种与肝脏疾病。
COVID-19 vaccination and liver disease.
机构信息
Department of Gastroenterology, Faculty of Medicine, Oita University, Yufu 879-5593, Oita, Japan.
Department of Infectious Disease Control, Faculty of Medicine, Oita University, Yufu 879-5593, Oita, Japan.
出版信息
World J Gastroenterol. 2022 Dec 28;28(48):6791-6810. doi: 10.3748/wjg.v28.i48.6791.
Various vaccines against severe acute respiratory syndrome coronavirus 2 have been developed in response to the coronavirus disease 2019 (COVID-19) global pandemic, several of which are highly effective in preventing COVID-19 in the general population. Patients with chronic liver diseases (CLDs), particularly those with liver cirrhosis, are considered to be at a high risk for severe COVID-19 and death. Given the increased rates of disease severity and mortality in patients with liver disease, there is an urgent need to understand the efficacy of vaccination in this population. However, the data regarding efficacy and safety of COVID-19 vaccination in patients with CLDs is limited. Indeed, several organ-specific or systemic immune-mediated side effects following COVID-19 vaccination, including liver injury similar to autoimmune hepatitis, have been recently reported. Although the number of cases of vaccine-related liver injury is increasing, its frequency, clinical course, and mechanism remain unclear. Here, we review the current findings on COVID-19 vaccination and liver disease, focusing on: (1) The impact of COVID-19 in patients with CLD; (2) The efficacy, safety, and risk-benefit profiles of COVID-19 vaccines in patients with CLD; and (3) Liver injury following COVID-19 vaccination.
为应对 2019 年冠状病毒病(COVID-19)全球大流行,已经开发出多种针对严重急性呼吸综合征冠状病毒 2 的疫苗,其中几种在普通人群中预防 COVID-19 的效果非常显著。患有慢性肝病(CLD)的患者,尤其是患有肝硬化的患者,被认为患严重 COVID-19 和死亡的风险较高。鉴于肝病患者的疾病严重程度和死亡率增加,迫切需要了解该人群的疫苗接种效果。然而,关于 COVID-19 疫苗接种在 CLD 患者中的疗效和安全性的数据有限。事实上,最近已经报道了 COVID-19 疫苗接种后包括类似于自身免疫性肝炎的肝损伤在内的几种器官特异性或系统性免疫介导的副作用。尽管与疫苗相关的肝损伤的病例数在增加,但它的频率、临床过程和机制仍不清楚。在这里,我们回顾了 COVID-19 疫苗接种和肝病的最新发现,重点关注:(1)COVID-19 对 CLD 患者的影响;(2)COVID-19 疫苗在 CLD 患者中的疗效、安全性和风险效益概况;以及(3)COVID-19 疫苗接种后的肝损伤。