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Postvaccination COVID-19 infection is associated with reduced mortality in patients with cirrhosis.
John, Binu V; Deng, Yangyang; Schwartz, Kaley B; Taddei, Tamar H; Kaplan, David E; Martin, Paul; Chao, Hann-Hsiang; Dahman, Bassam.
  • John BV; Division of Hepatology, Miami VA Health System, Miami, Florida, USA.
  • Deng Y; Division of Digestive Health and Liver Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA.
  • Schwartz KB; Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia, USA.
  • Taddei TH; Division of Hepatology, Miami VA Health System, Miami, Florida, USA.
  • Kaplan DE; Section of Digestive Diseases, Yale School of Medicine, New Haven, Connecticut, USA.
  • Martin P; VA Connecticut Healthcare System, West Haven, Connecticut, USA.
  • Chao HH; Division of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
  • Dahman B; Division of Gastroenterology and Hepatology, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA.
Hepatology ; 76(1): 126-138, 2022 07.
Article in English | MEDLINE | ID: covidwho-1705290
ABSTRACT
BACKGROUND AND

AIMS:

Patients develop breakthrough COVID-19 infection despite vaccination. The aim of this study was to identify outcomes in patients with cirrhosis who developed postvaccination COVID-19.

METHODS:

We performed a retrospective cohort study among US veterans with cirrhosis and postvaccination or unvaccinated COVID-19. Patients were considered fully vaccinated if COVID-19 was diagnosed 14 days after the second dose of either the Pfizer BNT162b2, the Moderna 1273-mRNA, or the single-dose Janssen Ad.26.COV2.S vaccines and partially vaccinated if COVID-19 was diagnosed 7 days after the first dose of any vaccine but prior to full vaccination. We investigated the association of postvaccination COVID-19 with mortality.

RESULTS:

We identified 3242 unvaccinated and 254 postvaccination COVID-19 patients with cirrhosis (82 after full and 172 after partial vaccination). In a multivariable analysis of a 12 propensity-matched cohort including vaccinated (n = 254) and unvaccinated (n = 508) participants, postvaccination COVID-19 was associated with reduced risk of death (adjusted HR [aHR], 0.21; 95% CI, 0.11-0.42). The reduction was observed after both full (aHR, 0.22; 95% CI, 0.08-0.63) and partial (aHR, 0.19; 95% CI, 0.07-0.54) vaccination, following the 1273-mRNA (aHR, 0.12; 95% CI 0.04-0.37) and BNT162b2 (aHR, 0.27; 95% CI, 0.10-0.71) vaccines and among patients with compensated (aHR, 0.19; 95% CI, 0.08-0.45) and decompensated (aHR, 0.27; 95% CI, 0.08-0.90) cirrhosis. Findings were consistent in a sensitivity analysis restricted to participants who developed COVID-19 after vaccine availability.

CONCLUSIONS:

Though patients with cirrhosis can develop breakthrough COVID-19 after full or partial vaccination, these infections are associated with reduced mortality.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Vaccines Limits: Humans Language: English Journal: Hepatology Year: 2022 Document Type: Article Affiliation country: Hep.32337

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Vaccines Limits: Humans Language: English Journal: Hepatology Year: 2022 Document Type: Article Affiliation country: Hep.32337