Cirrhosis is associated with lower serological responses to COVID-19 vaccines in patients with chronic liver disease
| Autor(a) principal: | |
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| Data de Publicação: | 2023 |
| Outros Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
| Texto Completo: | http://hdl.handle.net/10451/57127 |
Resumo: | © 2023 The Authors. Published by Elsevier B.V. on behalf of European Association for the Study of the Liver (EASL). This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
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Cirrhosis is associated with lower serological responses to COVID-19 vaccines in patients with chronic liver diseaseCOVID-19 vaccineChronic liver diseaseCirrhosisHumoral immunitySARS-CoV-2© 2023 The Authors. Published by Elsevier B.V. on behalf of European Association for the Study of the Liver (EASL). This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Background & aims: The response of patients with chronic liver disease (CLD) to COVID-19 vaccines remains unclear. Our aim was to assess the humoral immune response and efficacy of two-dose COVID-19 vaccines among patients with CLD of different aetiologies and disease stages. Methods: A total of 357 patients were recruited in clinical centres from six European countries, and 132 healthy volunteers served as controls. Serum IgG (nM), IgM (nM), and neutralising antibodies (%) against the Wuhan-Hu-1, B.1.617, and B.1.1.529 SARS-CoV-2 spike proteins were determined before vaccination (T0) and 14 days (T2) and 6 months (T3) after the second-dose vaccination. Patients fulfilling inclusion criteria at T2 (n = 212) were stratified into 'low' or 'high' responders according to IgG levels. Infection rates and severity were collected throughout the study. Results: Wuhan-Hu-1 IgG, IgM, and neutralisation levels significantly increased from T0 to T2 in patients vaccinated with BNT162b2 (70.3%), mRNA-1273 (18.9%), or ChAdOx1 (10.8%). In multivariate analysis, age, cirrhosis, and type of vaccine (ChAdOx1 > BNT162b2 > mRNA-1273) predicted 'low' humoral response, whereas viral hepatitis and antiviral therapy predicted 'high' humoral response. Compared with Wuhan-Hu-1, B.1.617 and, further, B.1.1.529 IgG levels were significantly lower at both T2 and T3. Compared with healthy individuals, patients with CLD presented with lower B.1.1.529 IgGs at T2 with no additional key differences. No major clinical or immune IgG parameters associated with SARS-CoV-2 infection rates or vaccine efficacy. Conclusions: Patients with CLD and cirrhosis exhibit lower immune responses to COVID-19 vaccination, irrespective of disease aetiology. The type of vaccine leads to different antibody responses that appear not to associate with distinct efficacy, although this needs validation in larger cohorts with a more balanced representation of all vaccines. Impact and implications: In patients with CLD vaccinated with two-dose vaccines, age, cirrhosis, and type of vaccine (Vaxzevria > Pfizer BioNTech > Moderna) predict a 'lower' humoral response, whereas viral hepatitis aetiology and prior antiviral therapy predict a 'higher' humoral response. This differential response appears not to associate with SARS-CoV-2 infection incidence or vaccine efficacy. However, compared with Wuhan-Hu-1, humoral immunity was lower for the Delta and Omicron variants, and all decreased after 6 months. As such, patients with CLD, particularly those older and with cirrhosis, should be prioritised for receiving booster doses and/or recently approved adapted vaccines.Partial funds were provided through Fundação para a Ciência e a Tecnologia (grants PTDC/MED-PAT/31882/2017 and EXPL/MED-OUT/1317/2021) and through La Caixa Scientific Foundation (grant HR17-00601).ElsevierRepositório da Universidade de LisboaSimão, AndréPalma, CarolinaIzquierdo-Sanchez, LauraPutignano, AntonellaCarvalho-Gomes, AngelaPosch, AndreasZanaga, PaolaGirleanu, IrinaHenrique, MarianaAraújo, CarlosDegre, DelphineGustot, ThierrySahuco, IvánSpagnolo, EliaCarvalhana, SofiaMoura, MiguelFernandes, Diogo AE.Banales, Jesus M.Romero-Gomez, ManuelTrifan, AncaRusso, Francesco PaoloStauber, RudolfBerenguer, MarinaMoreno, ChristopheGonçalves, João manuel brazCortez-Pinto, HelenaCastro, Rui E.2023-04-13T16:53:18Z20232023-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10451/57127engJHEP Rep. 2023 May;5(5):10069710.1016/j.jhepr.2023.1006972589-5559info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-11-08T17:05:10Zoai:repositorio.ul.pt:10451/57127Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T22:07:33.297874Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
| dc.title.none.fl_str_mv |
Cirrhosis is associated with lower serological responses to COVID-19 vaccines in patients with chronic liver disease |
| title |
Cirrhosis is associated with lower serological responses to COVID-19 vaccines in patients with chronic liver disease |
| spellingShingle |
Cirrhosis is associated with lower serological responses to COVID-19 vaccines in patients with chronic liver disease Simão, André COVID-19 vaccine Chronic liver disease Cirrhosis Humoral immunity SARS-CoV-2 |
| title_short |
Cirrhosis is associated with lower serological responses to COVID-19 vaccines in patients with chronic liver disease |
| title_full |
Cirrhosis is associated with lower serological responses to COVID-19 vaccines in patients with chronic liver disease |
| title_fullStr |
Cirrhosis is associated with lower serological responses to COVID-19 vaccines in patients with chronic liver disease |
| title_full_unstemmed |
Cirrhosis is associated with lower serological responses to COVID-19 vaccines in patients with chronic liver disease |
| title_sort |
Cirrhosis is associated with lower serological responses to COVID-19 vaccines in patients with chronic liver disease |
| author |
Simão, André |
| author_facet |
Simão, André Palma, Carolina Izquierdo-Sanchez, Laura Putignano, Antonella Carvalho-Gomes, Angela Posch, Andreas Zanaga, Paola Girleanu, Irina Henrique, Mariana Araújo, Carlos Degre, Delphine Gustot, Thierry Sahuco, Iván Spagnolo, Elia Carvalhana, Sofia Moura, Miguel Fernandes, Diogo AE. Banales, Jesus M. Romero-Gomez, Manuel Trifan, Anca Russo, Francesco Paolo Stauber, Rudolf Berenguer, Marina Moreno, Christophe Gonçalves, João manuel braz Cortez-Pinto, Helena Castro, Rui E. |
| author_role |
author |
| author2 |
Palma, Carolina Izquierdo-Sanchez, Laura Putignano, Antonella Carvalho-Gomes, Angela Posch, Andreas Zanaga, Paola Girleanu, Irina Henrique, Mariana Araújo, Carlos Degre, Delphine Gustot, Thierry Sahuco, Iván Spagnolo, Elia Carvalhana, Sofia Moura, Miguel Fernandes, Diogo AE. Banales, Jesus M. Romero-Gomez, Manuel Trifan, Anca Russo, Francesco Paolo Stauber, Rudolf Berenguer, Marina Moreno, Christophe Gonçalves, João manuel braz Cortez-Pinto, Helena Castro, Rui E. |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author |
| dc.contributor.none.fl_str_mv |
Repositório da Universidade de Lisboa |
| dc.contributor.author.fl_str_mv |
Simão, André Palma, Carolina Izquierdo-Sanchez, Laura Putignano, Antonella Carvalho-Gomes, Angela Posch, Andreas Zanaga, Paola Girleanu, Irina Henrique, Mariana Araújo, Carlos Degre, Delphine Gustot, Thierry Sahuco, Iván Spagnolo, Elia Carvalhana, Sofia Moura, Miguel Fernandes, Diogo AE. Banales, Jesus M. Romero-Gomez, Manuel Trifan, Anca Russo, Francesco Paolo Stauber, Rudolf Berenguer, Marina Moreno, Christophe Gonçalves, João manuel braz Cortez-Pinto, Helena Castro, Rui E. |
| dc.subject.por.fl_str_mv |
COVID-19 vaccine Chronic liver disease Cirrhosis Humoral immunity SARS-CoV-2 |
| topic |
COVID-19 vaccine Chronic liver disease Cirrhosis Humoral immunity SARS-CoV-2 |
| description |
© 2023 The Authors. Published by Elsevier B.V. on behalf of European Association for the Study of the Liver (EASL). This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
| publishDate |
2023 |
| dc.date.none.fl_str_mv |
2023-04-13T16:53:18Z 2023 2023-01-01T00:00:00Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
| dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10451/57127 |
| url |
http://hdl.handle.net/10451/57127 |
| dc.language.iso.fl_str_mv |
eng |
| language |
eng |
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JHEP Rep. 2023 May;5(5):100697 10.1016/j.jhepr.2023.100697 2589-5559 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
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Elsevier |
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Elsevier |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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