Beran Azizullah, Mhanna Asmaa, Mhanna Mohammed, Hassouneh Ramzi, Abuhelwa Ziad, Mohamed Mouhand F H, Sayeh Wasef, Musallam Rami, Assaly Ragheb, Abdeljawad Khaled
Division of Gastroenterology and Hepatology, Indiana University, Indianapolis, Indiana.
Department of Pediatrics, ProMedica Hospital, Toledo, Ohio.
Proc (Bayl Univ Med Cent). 2023 Jan 17;36(2):151-156. doi: 10.1080/08998280.2023.2165344. eCollection 2023.
SARS-CoV-2 vaccinations were found to be highly effective in phase 3 clinical trials. However, these trials have not reported data regarding the subgroup of liver disease or excluded patients with liver disease. The effectiveness of COVID-19 vaccines among liver cirrhosis (LC) patients is unclear. We conducted this meta-analysis to assess the effectiveness of SARS-CoV-2 vaccination in LC patients. A comprehensive literature search was conducted to include all the relevant studies that compared the outcomes of LC patients who received SARS-CoV-2 vaccines vs. unvaccinated patients. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated by the Mantel-Haenszel method within a random-effect model. Four studies with 51,834 LC patients (20,689 patients received at least one dose vs 31,145 were unvaccinated) were included. COVID-19-related complications, including hospitalization (RR 0.73, 95% CI 0.59-0.91, = 0.004), mortality (RR 0.29, 95% CI 0.16-0.55, = 0.0001), and need for invasive mechanical ventilation (RR 0.29, 95% CI 0.11-0.77, = 0.01), were significantly lower in the vaccinated group compared to the unvaccinated group. SARS-CoV-2 vaccination in LC patients reduced COVID-19-related mortality, intubation, and hospitalization. SARS-CoV-2 vaccination is highly effective in LC. Further prospective studies, preferably randomized controlled trials, are necessary to validate our findings and determine which vaccine is superior in patients with LC.
在3期临床试验中发现，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）疫苗非常有效。然而，这些试验并未报告有关肝病亚组的数据，也未排除肝病患者。2019冠状病毒病（COVID-19）疫苗在肝硬化（LC）患者中的有效性尚不清楚。我们进行了这项荟萃分析，以评估SARS-CoV-2疫苗接种在LC患者中的有效性。进行了全面的文献检索，纳入了所有比较接受SARS-CoV-2疫苗的LC患者与未接种疫苗患者结局的相关研究。采用随机效应模型，通过Mantel-Haenszel方法计算合并风险比（RR）及95%置信区间（CI）。纳入了四项研究，共51834例LC患者（20689例患者接受了至少一剂疫苗，31145例未接种疫苗）。与COVID-19相关的并发症，包括住院（RR 0.73，95%CI 0.59-0.91，P = 0.004）、死亡率（RR 0.29，95%CI 0.16-0.55，P = 0.0001）和有创机械通气需求（RR 0.29，95%CI 0.11-0.77，P = 0.01），接种疫苗组显著低于未接种疫苗组。LC患者接种SARS-CoV-2疫苗可降低与COVID-19相关的死亡率、插管率和住院率。SARS-CoV-2疫苗接种在LC患者中非常有效。需要进一步开展前瞻性研究，最好是随机对照试验，以验证我们的研究结果，并确定哪种疫苗对LC患者更具优势。
