Toutoudaki Konstantina, Dimakakou Melitini, Androutsakos Theodoros
First Department of Pediatrics, National and Kapodistrian University of Athens, 11527 Athens, Greece.
Department of Gynecology and Obstetrics, General Hospital of Chalkida, 34100 Chalkida, Greece.
Vaccines (Basel). 2023 Feb 16;11(2):452. doi: 10.3390/vaccines11020452.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19), has led to a pandemic with more than 6.5 million deaths worldwide. Patients with liver cirrhosis (PWLC) are regarded as prone to severe COVID-19. Vaccination against SARS-CoV-2 has been proven to be the most effective measure against COVID-19 and a variety of different vaccines have been approved for use; namely mRNA and vector-based, inactivated, whole virion, and protein subunit vaccines. Unfortunately, only a small number of PWLC were included in phase I-III vaccine trials, raising concerns regarding their efficacy and safety in this population. The authors, in this review, present available data regarding safety and efficacy of anti-SARS-CoV-2 vaccination in PWLC and discuss post-vaccination antibody responses. Overall, all vaccines seem to be extremely safe, with only a few and insignificant adverse events, and efficient, leading to lower rates of hospitalization and COVID-19-related mortality. T- and B-cell responses, on the other hand, remain an enigma, especially in patients with decompensated disease, since these patients show lower titers of anti-SARS-CoV-2 antibodies in some studies, with a more rapid waning. However, this finding is not consistent, and its clinical impact is still undetermined.
导致2019冠状病毒病（COVID-19）的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）已引发全球大流行，造成全球超过650万人死亡。肝硬化患者（PWLC）被认为易患重症COVID-19。事实证明，接种针对SARS-CoV-2的疫苗是预防COVID-19最有效的措施，多种不同的疫苗已获批使用；即信使核糖核酸（mRNA）疫苗和基于载体的疫苗、灭活疫苗、全病毒疫苗和蛋白亚单位疫苗。不幸的是，I至III期疫苗试验中纳入的PWLC数量很少，这引发了人们对这些疫苗在该人群中的有效性和安全性的担忧。在这篇综述中，作者介绍了关于PWLC接种抗SARS-CoV-2疫苗的安全性和有效性的现有数据，并讨论了接种疫苗后的抗体反应。总体而言，所有疫苗似乎都极其安全，只有少数轻微且不显著的不良事件，并且有效，可降低住院率和与COVID-19相关的死亡率。另一方面，T细胞和B细胞反应仍然是一个谜，尤其是在失代偿性疾病患者中，因为在一些研究中这些患者的抗SARS-CoV-2抗体滴度较低，且抗体滴度下降更快。然而，这一发现并不一致，其临床影响仍未确定。
