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Omicron infections profile and vaccination status among 1881 liver transplant recipients: a multi-centre
Ensi Ma1, Jingwen Ai2,3, Yi Zhang2,3
1Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.
Abstract:
ABSTRACTA 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.
Insights
Inactivated vaccines are safe for liver transplant recipients but offer low protection against Omicron COVID-19, with efficacy waning after six months. Boosted vaccinations are recommended for liver transplant patients.
Area of Science:
- Immunology
- Hepatology
- Infectious Diseases
Background:
- Omicron variant surged in China in 2022, with limited data on vaccine effectiveness and COVID-19 in liver transplant (LT) recipients.
- Assessing vaccine safety and protection against SARS-CoV-2 Omicron variant in LT patients is crucial.
Purpose of the Study:
- To evaluate the safety and protective efficacy of inactivated vaccines against Omicron variant infections in liver transplant recipients.
- To analyze COVID-19 infection characteristics and adverse events in vaccinated versus unvaccinated LT patients.
Main Methods:
- Multi-center retrospective study involving 1881 liver transplant recipients (487 vaccinated, 1394 unvaccinated).
- Data collected on Omicron infections, viral shedding, vaccine breakthrough cases, and adverse events post-vaccination.
Main Results:
- Low protection rate (2.59%) of inactivated vaccines against Omicron; breakthrough infections occurred >6 months post-vaccination.
- 19.7% of vaccinated patients reported adverse events; preoperative vaccination showed more Grade 3 events.
- Omicron infections were generally mild in LT patients, but unvaccinated individuals had higher risk of liver dysfunction.
Conclusions:
- Inactivated vaccines are safe for post-liver transplant patients.
- Vaccine efficacy wanes after 6 months, necessitating early booster vaccinations for LT recipients.
- Unvaccinated LT patients face a higher risk of liver dysfunction during Omicron infections.
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