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Meta-Analysis
. 2022 Oct;28(4):890-911.
doi: 10.3350/cmh.2022.0087. Epub 2022 Jun 3.

COVID-19 vaccine immunogenicity among chronic liver disease patients and liver transplant recipients: A meta-analysis

Ka Shing Cheung  1   2 , Chiu Hang Mok  3 , Xianhua Mao  1 , Ruiqi Zhang  1 , Ivan Fn Hung  1 , Wai Kay Seto  1   2   4 , Man Fung Yuen  1   4
Affiliations
Meta-Analysis

COVID-19 vaccine immunogenicity among chronic liver disease patients and liver transplant recipients: A meta-analysis

Ka Shing Cheung et al. Clin Mol Hepatol. 2022 Oct.

Abstract

Background/aims: Data of coronavirus disease 2019 (COVID-19) vaccine immunogenicity among chronic liver disease (CLD) and liver transplant (LT) patients are conflicting. We performed meta-analysis to examine vaccine immunogenicity regarding etiology, cirrhosis status, vaccine platform and type of antibody.

Methods: We collected data via three databases from inception to February 16, 2022, and reported pooled seroconversion rate, T cell response and safety data after two vaccine doses.

Results: Twenty-eight (CLD only: 5; LT only: 18; both: 2; LT with third dose: 3) observational studies of 3,945 patients were included. For CLD patients, seroconversion rate ranged between 84% (95% confidence interval [CI], 76-90%) and 91% (95% CI, 83-95%), based predominantly on neutralizing antibody and anti-spike antibody, respectively. Seroconversion rate was 81% (95% CI, 76-86%) in chronic hepatitis B, 96% (95% CI, 93-97%) in non-alcoholic fatty liver disease, 85% (95% CI, 75-91%) in cirrhosis and 85% (95% CI, 78-90%) in non-cirrhosis, 86% (95% CI, 78-92%) for inactivated vaccine and 89% (95% CI, 71-96%) for mRNA vaccine. The pooled seroconversion rate of anti-spike antibody was 66% (95% CI, 55-75%) after two doses of mRNA vaccines and 88% (95% CI, 58-98%) after third dose among LT recipients. T cell response rate was 65% (95% CI, 30-89%). Prevalence of adverse events was 27% (95% CI, 18-38%) and 63% (95% CI, 39-82%) among CLD and LT groups, respectively.

Conclusion: CLD patients had good humoral response to COVID-19 vaccine, while LT recipients had lower response.

Keywords: COVID-19; Chronic hepatitis B; Liver transplant; Non-alcoholic fatty liver disease; SARS-CoV-2.

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Conflict of interest statement

Conflicts of Interest

The authors have no conflicts to disclose.

Figures

Figure 1.
Figure 1.
Pooled seroconversion rate in chronic liver disease. CI, confidence interval.
Figure 2.
Figure 2.
Pooled seroconversion rate in chronic liver disease according to antibody type. CI, confidence interval; Ab, antibody.
Figure 3.
Figure 3.
Pooled seroconversion rate in chronic liver disease according to etiology and cirrhosis status. CI, confidence interval; CHB, chronic hepatitis B; NAFLD, non-alcoholic fatty liver disease.
Figure 4.
Figure 4.
Pooled seroconversion rate in liver transplant recipients. CI, confidence interval.
Figure 5.
Figure 5.
Pooled seroconversion rate in liver transplant recipients according to individual vaccine type. CI, confidence interval.
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