Physicians should continue efforts to vaccinate patients with cirrhosis against COVID-19
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LAS VEGAS — No safety and efficacy concerns for COVID-19 messenger RNA vaccines were noted among patients with cirrhosis compared with the general population, according to a presentation at the ACG Annual Scientific Meeting.
“In a large cohort of patients who received the messenger RNA (mRNA) COVID-19 vaccines in the U.S., we found that the efficacy and safety of these vaccines in patients with cirrhosis is similar to the general population without cirrhosis,” Yousaf B. Hadi, MD, a gastroenterology fellow in the department of medicine at West Virginia University, Morgantown, told Healio Gastroenterology. “This is encouraging data and considering that patients with cirrhosis are at higher risk of adverse outcomes of COVID-19 disease, we need continued efforts to vaccinate as many of these patients as possible.”
Hadi and colleagues performed a retrospective cohort using TriNetx to assess 402,202 patients who received an mRNA COVID-19 vaccine. Of these patients, 3,063 had cirrhosis. Outcomes from patients with cirrhosis were compared with those without it. Propensity-score matching was used to compare the groups. Investigators matched patients based on age, gender, ethnicity, BMI and comorbid conditions, including diabetes, chronic lower respiratory diseases, ischemic heart disease, heart failure, nicotine dependence and chronic kidney disease.
Results from the propensity-score matched assessment showed that after COVID-19 vaccination, no significant difference was found between the cirrhosis and non-cirrhosis groups with regard to the incidence of adverse events of special interest (RR = 1.29; 95% CI, 0.9-1.86) and new diagnosis of COVID-19 (RR = 1.27; 95% CI, 0.58-2.8).
Hadi said patients with cirrhosis had higher 30-day all-cause hospitalization after COVID-19 vaccination.
Results from subgroup analysis showed that after COVID-19 vaccination, patients with decompensated cirrhosis (RR = 1.23; 95% CI, 0.74-2.05) or compensated cirrhosis (RR = 1.48; 95% CI, 0.88-2.5), compared with patients without cirrhosis, did not have different 30-day adverse events of special interest. After vaccination, fewer than 10 patients in the decompensated cirrhosis and compensated cirrhosis subgroups received a new diagnosis of COVID-19, Hadi said.
“The next step in research is to analyze outcomes at a longer duration of follow-up to study if the efficacy decreases sooner in this cohort compared to the general population, or if booster doses can help in the cirrhosis cohort,” Hadi said.
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Hadi YB, et al. Abstract: S1060. Presented at: ACG Annual Scientific Meeting; Oct. 22-27, 2021; Las Vegas (hybrid meeting).
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