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COVID-19 Vaccination Effectiveness and Clinical Outcomes in Chronic Liver Disease: A Nationwide Retrospective Cohort

Jae Yoon Jeong1, Bomi Kim2, Danbee Kang3

  • 1Division of Gastroenterology, Department of Internal Medicine, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea.

Liver International : Official Journal of the International Association for the Study of the Liver
|June 4, 2026
PubMed

Insights

COVID-19 vaccination reduced COVID-19 risk, hospitalizations, and mortality in chronic liver disease (CLD) patients. However, vaccination did not significantly alter outcomes for those with decompensated cirrhosis, who faced a poor prognosis.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Public Health

Background:

  • Chronic liver disease (CLD) and decompensated cirrhosis are significant health concerns.
  • The impact of COVID-19 vaccination on this vulnerable population requires thorough investigation.

Purpose of the Study:

  • To evaluate the effectiveness of COVID-19 vaccination in patients with chronic liver disease (CLD), with a specific focus on those with decompensated cirrhosis.
  • To assess the impact of vaccination on COVID-19 incidence, hospitalization, and all-cause mortality.

Main Methods:

  • A population-based cohort study utilizing South Korean National Health Insurance Service data.
  • Included 1,583,777 patients with CLD, with a subgroup of 61,765 patients having decompensated cirrhosis.
  • Propensity score matching was employed to compare vaccinated and unvaccinated individuals.

Main Results:

  • COVID-19 vaccination was associated with a reduced risk of COVID-19, hospitalization, and all-cause mortality in the overall CLD cohort.
  • However, no statistically significant differences in clinical outcomes were observed for patients with decompensated cirrhosis post-vaccination.
  • Multivariable analysis confirmed vaccination's benefit for all-cause mortality in CLD, while decompensated cirrhosis independently increased mortality risk in COVID-19 patients.

Conclusions:

  • COVID-19 vaccination offers protection against infection, hospitalization, and mortality for individuals with chronic liver disease.
  • Patients with decompensated cirrhosis exhibit a poor prognosis irrespective of COVID-19 vaccination status, highlighting the severity of their condition.
Abstract

Keywords:
COVID‐19hospitalisationliver cirrhosisliver diseasesprognosisvaccination

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