Seroconversion and safety of Covid-19 vaccines in pa-tients with chronic liver disease and liver transplant: A systematic review.

Autor:	Elzouki AY; Department of Medicine, Hamad Medical Corporation, Doha, Qatar E-mail: aelzouki@hamad.qa ORCID ID: 000-0002-9132-1752.; College of Medicine, Qatar University, Doha, Qatar.; Weill Cornell Medicine-Qatar, Doha, Qatar., Elshafei MN; Department of Clinical Pharmacy, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar., Aziz A; Department of Medicine, Hamad Medical Corporation, Doha, Qatar E-mail: aelzouki@hamad.qa ORCID ID: 000-0002-9132-1752., Elzouki I; Department of Medicine, Hamad Medical Corporation, Doha, Qatar E-mail: aelzouki@hamad.qa ORCID ID: 000-0002-9132-1752., Waheed MA; Department of Medicine, Hamad Medical Corporation, Doha, Qatar E-mail: aelzouki@hamad.qa ORCID ID: 000-0002-9132-1752., Farooqui K; Department of Medicine, Hamad Medical Corporation, Doha, Qatar E-mail: aelzouki@hamad.qa ORCID ID: 000-0002-9132-1752., Azad AM; Department of Emergency Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar., Habas E; Department of Medicine, Hamad Medical Corporation, Doha, Qatar E-mail: aelzouki@hamad.qa ORCID ID: 000-0002-9132-1752., Danjuma MI; Department of Medicine, Hamad Medical Corporation, Doha, Qatar E-mail: aelzouki@hamad.qa ORCID ID: 000-0002-9132-1752.; College of Medicine, Qatar University, Doha, Qatar.; Weill Cornell Medicine-Qatar, Doha, Qatar.
Jazyk:	angličtina
Zdroj:	Qatar medical journal [Qatar Med J] 2023 Dec 12; Vol. 2023 (3), pp. 21. Date of Electronic Publication: 2023 Dec 12 (Print Publication: 2023).
DOI:	10.5339/qmj.2023.21
Abstrakt:	Background and Aims: As part of the COVID-19 control strategy, a growing number of vaccine portfolios evolved and got fast-tracked through regulatory agencies, with a limited examination of their efficacy and safety in vulnerable populations, such as patients with chronic conditions and immunocompromised states. Patients with chronic liver disease (CLD), and cohorts post liver transplant (LT) in particular, were underrepresented in the determinant trials of vaccine development, hence the paucity of data on their efficacy and safety in published literature. This systematic review aims to examine the available evidence and ascertain the effectiveness and safety of Covid-19 vaccination in patients with CLD and those with LT. Methods: A systematic review of PubMed (Medline), Google Scholar, Cochrane Library, and ScienceDirect from inception until 1 st March 2022 was conducted. We included observational studies and assessed vaccine efficacy regarding seroconversion or immunological rate, whereas serious or significant adverse effects have been considered safety outcomes when reported. Results: Studies comprised 45275 patients, performed in 11 different countries. Seroconversion or immunological rate after Covid-19 vaccination was mostly the primary endpoint, whereas other endpoints like covid-19 related adverse effects were also reported. Twenty-four of the final analyzed studies are prospective cohort studies, while four are retrospective cohort studies. Twenty-one studies included patients who underwent LT and received the Covid vaccine; nine included patients who had CLD due to various etiologies. The median age range of all included patients varied from 43-69 years. All patients with LT who received at least two doses of Covid vaccine had a seroconversion rate of around 60%. Patients with CLD had a seroconversion rate of about 92% post two doses of Covid vaccination. The average seroconversion rate in post-transplant recipients was around 45% after two doses of the significant Covid vaccines: Pfizer, AstraZeneca, Moderna, and Jansen. Only two studies have reported a higher seroconversion rate of 75% and 73% after the third dose of Covid vaccine. No significant adverse effects were reported in all studies; the most commonly reported negative effect was local injection site pain. Conclusion: The present systematic review, comprising real-world observational data studies, concludes that Covid-19 vaccination was associated with 92% and 60% seroconversion rates in patients with CLD and LT, respectively. No significant side effects were reported in all studies. This finding helps to resolve the uncertainty associated with Covid-19 vaccination in this cohort of patients. Competing Interests: The authors declared no conflicts of interest relevant to this review or its publication. (© 2023 Elzouki, Elshafei, Aziz, Elzouki, Waheed, Farooqui, Azad, Habas, Danjuma, Licensee HBKU Press.)
Databáze:	MEDLINE
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