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COVID-19 Vaccination in Patients with Chronic Liver Disease
Authors:Georgios Schinas  Eleni Polyzou  Fevronia Mitropetrou  Aristotelis Pazionis  Charalambos Gogos  Christos Triantos  Karolina Akinosoglou
Affiliation:1.Department of Internal Medicine, University General Hospital of Patras, 26504 Rio, Greece;2.Department of Medicine, University of Patras, 26504 Rio, Greece;3.Division of Gastroenterology, Department of Internal Medicine, University General Hospital of Patras, 26504 Rio, Greece
Abstract:Vaccination against SARS-CoV-2 has become a central public health issue, primarily for vulnerable populations such as individuals with Chronic Liver Disease (CLD). Increased COVID-19-related mortality and disease severity has been noted in this subgroup of patients. Severe COVID-19 tends to further deregulate liver function in patients with chronic liver failure or cirrhosis and even reactivate hepatitis in people living with HBV or HCV. In addition, impaired hepatic function leads to several limitations in possible therapeutic interventions. Chronic hepatic dysregulation, along with the underlying cirrhosis-associated immune dysfunction (CAID), leads to a decreased immune response to vaccination that, in turn, may result in reduced efficacy rates and lowered lasting protection. According to current guidelines, timely vaccination and frequent booster shot administration are deemed necessary in this context. Vaccination-related adverse events are mostly mild in nature and similar to those reported in the general population, whereas the incidence of liver injury following vaccination is relatively rare. We aimed to review available evidence and recommendations associated with COVID-19 vaccination in patients with chronic liver disease, and provide insight to current issues and future directions.
Keywords:COVID-19 vaccines   mRNA vaccine   chronic liver disease   immunization   SARS-CoV-2
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