Your browser doesn't support javascript.
INCIDENCE AND OUTCOMES OF COVID-19 IN POST-LIVER TRANSPLANT RECIPIENTS AFTER COVID-19 VACCINATION IN A LARGE INTEGRATED HEALTHCARE SYSTEM
Gastroenterology ; 162(7):S-1138, 2022.
Article in English | EMBASE | ID: covidwho-1967413
ABSTRACT
Background There is limited data on the efficacy of SARS-CoV-2 vaccinations on the immunosuppressed population—especially in the liver transplant (LT) population. A study in Israel found that only 47% of LT recipients developed adequate antibodies against the virus while another study in Baltimore, MD found an immune response of 81%. Moreover, early studies in San Diego, CA and Miami, FL on the outcomes of COVID-19 disease among solid organ transplant recipients showed reductions in symptomatic disease of 75 to 80%. We aim to identify the incidence and outcomes of COVID-19 disease in fully vaccinated LT recipients in a large cohort of LT recipients. Methods In a large integrated healthcare system in Southern California with a population of 4.3 million active members aged 18 or older, data was extracted from the electronic health record (EHR) and transplant registry. COVID-19 disease was identified by a positive polymerase chain reaction (PCR) test for SARS-CoV-2. We defined fully vaccinated as 14 days after the 2nd dose of Pfizer or Moderna vaccines or after the 1st dose of Johnson and Johnson vaccine. Chi square analysis was used to compare the difference between 2 groups. Results We identified 1271 active members who had received a LT as of 12/1/2021. Among LT recipients, 90.6% (1152/1271) had received at least one dose of a COVID-19 vaccination, 89.1% (1132/1271) were fully vaccinated, and 58.6% (745/1271) had received booster vaccinations. Between 3/1/20 and 11/30/21, 172 (13.5%) LT recipients had been infected with COVID-19 disease, of which, 37 (3.3%) were infected after being fully vaccinated. Of those infected after being fully vaccinated, 38.9% (15/37) were female. The mean age was 58.7 ± 9.8. 62.2% had diabetes, 73.0% had hypertension, and the mean body mass index (BMI) was 29.3 ± 5.8. 24.3% (9/37) were hospitalized for COVID-19-related illness. The case fatality of COVID-19 was 2.7% (1/37) in post-vaccinated LT recipients compared with 7.4% (10/135) who were unvaccinated prior to infection (OR 0.35, 95% CI 0.04-2.80, p = 0.27). The patient who passed away from COVID-19 after vaccination (diagnosed 4 months after receiving the second dose) had chronic kidney disease and obesity (BMI 42). Conclusions In our large cohort of LT recipients, a significant proportion were fully vaccinated, and the majority had received a booster vaccination dose. A small proportion of LT recipients were infected with COVID-19 disease after being fully vaccinated for COVID-19. The case fatality rate, although not statistically significant, of patients infected post-vaccination was lower compared to unvaccinated patients. More research is needed on the long-term outcomes of COVID-19 and vaccine efficacy in this high-risk population.
Keywords

Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Observational study Topics: Vaccines Language: English Journal: Gastroenterology Year: 2022 Document Type: Article

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Observational study Topics: Vaccines Language: English Journal: Gastroenterology Year: 2022 Document Type: Article