Omicron infections profile and vaccination status among 1881 liver transplant recipients: a multi-centre retrospective cohort

Abstract

A wave of Omicron infections rapidly emerged in China in 2022, but large-scale data concerning the safety profile of vaccines and Coronavirus disease 2019 (COVID-19) infection features in liver transplant (LT) recipients have not been collected. Therefore, the aim of this study was to assess the protectiveness and safety profile of the inactivated vaccines in LT patients against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant infections. A multi-centre retrospective study was conducted in a cohort with a history of liver transplantation. A total of 1881 participants (487 vaccinated and 1394 unvaccinated patients) were enrolled from seven centres in China. Fourteen of the participants were infected by Omicron, and 50% patients had over 14 days of viral shedding duration. The protection rate of COVID-19 vaccinations to Omicron was 2.59%. The three breakthrough infections occurred more than 6 months after fully vaccinated. A total of 96 (19.7%) vaccinated patients had adverse events, including fatigue, myalgia, liver dysfunction, swelling, and scleroma. There were more Grade 3 adverse events in the preoperative vaccination group than those in the postoperative vaccination group. Inactivated whole-virion SARS-CoV-2 vaccines are safe in patients with post-liver transplantation. The efficacy of inactivated vaccines decreases after 6 months of vaccination, it is recommended that liver transplant patients get boosted vaccinations as early as possible even when they are fully vaccinated. Although clinical manifestations of Omicron infections were mild in LT patients, unvaccinated patients might have a higher risk of liver dysfunction during infections.

Understanding the Elevated Lethality of COVID-19 in Liver Transplant Recipients: Does Immunosuppression Management Matter? Results from a Brazilian Multicentric Historical Cohort

“…Although these characteristics set the sample apart from most vaccinated LT recipients, such differences may be attenuated by evidence of the lower effectiveness of vaccines in this population [ 10 , 11 ]. Moreover, the results may still represent the fraction of patients with incomplete or absent vaccination, knowingly those in which more deaths and severe cases currently occur (and those in which more concerns are raised regarding modifications to immunosuppression) [12] , [13] , [14] .…”

Inactivated vaccines reduce the risk of liver function abnormality in NAFLD patients with COVID-19: a multi-center retrospective study

“…The primary composite outcome was liver function abnormality. Liver function abnormality was defined as an increase over the upper limit of the normal range 5 , 27 , 29 , 30 within the week of COVID-19 diagnosis in any of the following parameters: alanine aminotransferase (ALT, >50 U/L), aspartate aminotransferase (AST, >35 U/L), γ-glutamyl transpeptidase (GGT, >60 U/L), alkaline phosphatase (ALP, >135 U/L), total bilirubin (TBIL, >21 U/L), or direct bilirubin (DBIL, >5.1 U/L). The secondary outcome was viral shedding duration, which was defined as the number of days from the date of the first positive PCR test result to the date of the first negative PCR test result, followed by consecutive negative results.…”

“…The secondary outcome was viral shedding duration, which was defined as the number of days from the date of the first positive PCR test result to the date of the first negative PCR test result, followed by consecutive negative results. 29 Data including demographics, medical history, liver function, and viral shedding duration were extracted from the electronic medical records in the relevant registries.…”

Clinical characteristics and short-term outcomes of acute pancreatitis among patients with COVID-19

“…Although strict epidemic prevention measures have led to a decline in the number of COVID-19 infections, China made adjustments to its epidemic prevention policy on December 7, 2022, resulting in a surge in cases from December 2022 to January 2023. During this period, the primary variant circulating in China was Omicron [ 16 ]. Previous studies have shown a significantly increased risk of adverse outcomes and a mortality rate close to 20% in patients with concurrent AP and COVID-19 [ 17 ].…”