Background And Aims: The incidence and outcomes of breakthrough SARS-CoV-2 infections in vaccinated chronic liver disease (CLD) patients have not been well-characterized in non-veteran populations. We used the National COVID Cohort Collaborative (N3C), a dataset of 10.7 million patients, of whom 0.9 million have vaccination data, to describe outcomes in vaccinated CLD patients.
Methods: We identified all CLD patients with or without cirrhosis regardless of vaccination status who had SARS-CoV-2 testing in the N3C Data Enclave as of 1/15/2022. We used Poisson regression to estimate incidence rates of breakthrough infections and Cox survival analyses to associate vaccination status with all-cause mortality at 30 days among infected CLD patients.
Results: We isolated 278,457 total CLD patients: 43,079 (15%) vaccinated and 235,378 (85%) unvaccinated. Of the 43,079 vaccinated CLD patients, 32,838 (76%) were without cirrhosis and 10,441 (24%) were with cirrhosis. Estimated incidence rates for breakthrough infections were 5.6 and 5.1 per 1,000 person-months for 27,235 fully vaccinated CLD patients without cirrhosis and for 8,218 fully vaccinated CLD patients with cirrhosis, respectively.Of the 68,048 unvaccinated and 10,441 vaccinated CLD patients with cirrhosis in our cohort, 15% and 3.7%, respectively, developed SARS-CoV-2 infection. The combined 30-day all-cause rate of mechanical ventilation (without death) or death after SARS-CoV-2 infection for unvaccinated and vaccinated CLD patients with cirrhosis were 15.2% and 7.7%, respectively. Compared to unvaccinated patients with cirrhosis, full vaccination was associated with a 0.34-times adjusted hazard of death at 30 days.
Conclusions: In this N3C Data Enclave study, breakthrough infection rates were similar amongst CLD patients with and without cirrhosis. Full vaccination was associated with a 66% reduction in risk of all-cause mortality among CLD patients with cirrhosis after infection. These results provide an additional impetus for increasing vaccination uptake among patients with severe liver disease.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9275663 | PMC |
| http://dx.doi.org/10.1101/2022.02.25.22271490 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Non-Invasive Biomarkers and Breath Tests for Diagnosis and Monitoring of Chronic Liver Diseases.
Diagnostics (Basel)
December 2024
Pediatric Liver Center, Department of Pediatric Gastroenterology, Hepatology and Nutrition, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
Chronic liver disease (CLD) presents a significant global health burden, demanding effective tools for diagnosis and monitoring. Traditionally, liver biopsy has been the gold standard for evaluating liver fibrosis and other chronic liver conditions. However, biopsy's invasiveness, associated risks, and sampling variability indicate the need for reliable, noninvasive alternatives.
View Article and Find Full Text PDFTwo-Dimensional Shear-Wave Elastography: Accuracy in Liver Fibrosis Staging Using Magnetic Resonance Elastography as the Reference Standard.
Diagnostics (Basel)
December 2024
Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
The accurate staging of liver fibrosis is crucial for managing chronic liver disease (CLD). Although magnetic resonance elastography (MRE) is the reference standard for noninvasive fibrosis assessment, its cost, specialized hardware, and operational demands restrict accessibility. In contrast, two-dimensional shear-wave elastography (2D-SWE) is more affordable, accessible, and widely integrated into routine ultrasound systems.
View Article and Find Full Text PDFLiver damage and immune responses.
Z Gastroenterol
January 2025
Institut für Molekulare Immunologie, Technische Universität München, München, Germany.
Chronic liver disease (CLD) has massive systemic repercussions including major impacts on the body's immune system. Abnormalities in phenotype, function and numbers of various immune cell subsets have been established by a large number of clinical and pre-clinical studies. The loss of essential immune functions renders CLD-patients exceptionally susceptible to bacterial and viral infections and also impairs the efficacy of vaccination.
View Article and Find Full Text PDFXylometazoline-induced change in aspirated nasal nitric oxide detects obstructed paranasal ostia.
J Breath Res
January 2025
Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön Katu 34, Tampere, 33520, FINLAND.
The concentrations of nasal nitric oxide (nNO) vary in patients with chronic rhinosinusitis (CRS) supposedly depending upon whether the paranasal ostia are open or obstructed. Our aim was to assess whether nNO levels and their response to topical xylometazoline (a local vasoconstrictor used to alleviate nasal congestion) in patients with CRS differ between those with open or obstructed ostia and if the results were altered by the use of nasal corticosteroids. Methodology: Sixty-six patients with CRS (43% with nasal polyps) or recurrent acute rhinosinusitis and 23 healthy controls were included.
View Article and Find Full Text PDFMulti-site, multi-vendor development and validation of a deep learning model for liver stiffness prediction using abdominal biparametric MRI.
Eur Radiol
January 2025
Imaging Research Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Background: Chronic liver disease (CLD) is a substantial cause of morbidity and mortality worldwide. Liver stiffness, as measured by MR elastography (MRE), is well-accepted as a surrogate marker of liver fibrosis.
Purpose: To develop and validate deep learning (DL) models for predicting MRE-derived liver stiffness using routine clinical non-contrast abdominal T1-weighted (T1w) and T2-weighted (T2w) data from multiple institutions/system manufacturers in pediatric and adult patients.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!