tetano
Editor, Senior Moderator
Hepatology
. 2022 Jun 16.
doi: 10.1002/hep.32619. Online ahead of print.
Comparison of Infection-induced and Vaccine-induced Immunity Against Coronavirus 2019 in Patients with Cirrhosis
Binu V John[SUP] 1 2 [/SUP], Akash Doshi[SUP] 1 3 [/SUP], Raphaella D Ferreira[SUP] 1 [/SUP], Tamar H Taddei[SUP] 4 5 [/SUP], David E Kaplan[SUP] 6 7 [/SUP], Seth A Spector[SUP] 8 9 [/SUP], Yangyang Deng[SUP] 10 [/SUP], Dustin Bastaich[SUP] 10 [/SUP], Bassam Dahman[SUP] 10 [/SUP]
Affiliations
Abstract
Background and aims: Immunity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be infection or vaccine-induced. Cirrhosis is associated with vaccine hyporesponsiveness, but whether there is decreased immunity after SARS-CoV-2 infection in unvaccinated patients with cirrhosis is unknown. The objective of our study was to compare infection-induced and vaccine-induced immunity against coronavirus 2019 (COVID-19) among patients with cirrhosis.
Methods: This was a retrospective cohort study among US Veterans with cirrhosis between 11/27/20 and 11/16/21, comparing a vaccine-induced immunity group, defined as participants without a documented SARS-CoV-2 infection but fully vaccinated with two doses of an mRNA vaccine, and infection-associated immunity group, defined as unvaccinated participants who had a positive SARS-CoV-2 PCR. Both groups were propensity score matched for observed characteristics, including location, and the date of the immunity acquiring event, to control for the community prevalence of COVID-19 variants. The outcome was a positive SARS-CoV-2 PCR more than 60 days after previous infection in the infection-induced, or after full vaccination in the vaccine-induced immunity group.
Results: We compared 634 participants in the infection-induced immunity group with 27,131 participants in the vaccine-induced immunity group using inverse propensity of treatment weighting. Vaccine-induced immunity was associated with a reduced odds of developing SARS-CoV-2 infection (aHR 0.18, 95% CI 0.16-0.20, p<0.0001). On multivariable logistic regression, vaccine-induced immunity was associated with reduced odds of developing symptomatic (aOR 0.36, 95% CI 0.33-0.41, p<0.0001), moderate/severe/critical (aOR 0.27, 95% CI 0.22-0.31, p<0.0001), and severe or critical COVID-19 (aOR 0.20, 95% CI 0.16-0.26, p<0.001), compared to infection-induced immunity.
Conclusions: In participants with cirrhosis, vaccine-induced immunity is associated with reduced risk of developing COVID-19, compared to infection-induced immunity.
. 2022 Jun 16.
doi: 10.1002/hep.32619. Online ahead of print.
Comparison of Infection-induced and Vaccine-induced Immunity Against Coronavirus 2019 in Patients with Cirrhosis
Binu V John[SUP] 1 2 [/SUP], Akash Doshi[SUP] 1 3 [/SUP], Raphaella D Ferreira[SUP] 1 [/SUP], Tamar H Taddei[SUP] 4 5 [/SUP], David E Kaplan[SUP] 6 7 [/SUP], Seth A Spector[SUP] 8 9 [/SUP], Yangyang Deng[SUP] 10 [/SUP], Dustin Bastaich[SUP] 10 [/SUP], Bassam Dahman[SUP] 10 [/SUP]
Affiliations
- PMID: 35712794
- DOI: 10.1002/hep.32619
Abstract
Background and aims: Immunity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be infection or vaccine-induced. Cirrhosis is associated with vaccine hyporesponsiveness, but whether there is decreased immunity after SARS-CoV-2 infection in unvaccinated patients with cirrhosis is unknown. The objective of our study was to compare infection-induced and vaccine-induced immunity against coronavirus 2019 (COVID-19) among patients with cirrhosis.
Methods: This was a retrospective cohort study among US Veterans with cirrhosis between 11/27/20 and 11/16/21, comparing a vaccine-induced immunity group, defined as participants without a documented SARS-CoV-2 infection but fully vaccinated with two doses of an mRNA vaccine, and infection-associated immunity group, defined as unvaccinated participants who had a positive SARS-CoV-2 PCR. Both groups were propensity score matched for observed characteristics, including location, and the date of the immunity acquiring event, to control for the community prevalence of COVID-19 variants. The outcome was a positive SARS-CoV-2 PCR more than 60 days after previous infection in the infection-induced, or after full vaccination in the vaccine-induced immunity group.
Results: We compared 634 participants in the infection-induced immunity group with 27,131 participants in the vaccine-induced immunity group using inverse propensity of treatment weighting. Vaccine-induced immunity was associated with a reduced odds of developing SARS-CoV-2 infection (aHR 0.18, 95% CI 0.16-0.20, p<0.0001). On multivariable logistic regression, vaccine-induced immunity was associated with reduced odds of developing symptomatic (aOR 0.36, 95% CI 0.33-0.41, p<0.0001), moderate/severe/critical (aOR 0.27, 95% CI 0.22-0.31, p<0.0001), and severe or critical COVID-19 (aOR 0.20, 95% CI 0.16-0.26, p<0.001), compared to infection-induced immunity.
Conclusions: In participants with cirrhosis, vaccine-induced immunity is associated with reduced risk of developing COVID-19, compared to infection-induced immunity.