Clinical outcomes of COVID-19 infection in liver transplant recipients based on vaccination status
BackgroundCOVID-19 disease burden has been mitigated by vaccination; however, concerns persist regarding weakened immune responses in liver transplant (LT) recipients. This study investigates COVID-19 outcomes in LT recipients based on vaccination status.MethodsThis single-center retrospective study...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Transplantation |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/frtra.2024.1515964/full |
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| author | Vinathi Polamraju Neeta Vachharajani Brian F. Gage Jeffrey S. Crippin William C. Chapman |
| author_facet | Vinathi Polamraju Neeta Vachharajani Brian F. Gage Jeffrey S. Crippin William C. Chapman |
| author_sort | Vinathi Polamraju |
| collection | DOAJ |
| description | BackgroundCOVID-19 disease burden has been mitigated by vaccination; however, concerns persist regarding weakened immune responses in liver transplant (LT) recipients. This study investigates COVID-19 outcomes in LT recipients based on vaccination status.MethodsThis single-center retrospective study identified LT recipients with PCR-confirmed COVID-19 infection from 03/01/2020 to 07/31/2023. Logistic regression analyses were conducted, adjusting for age, race, co-morbidities, number of immunosuppressive agents, and infection date.ResultsOf 1,787 registered LT recipients, 361 had confirmed COVID-19 infection. Of those, 136 were unvaccinated and 225 were vaccinated. 13% had 1 vaccine dose, 31% had 2 vaccine doses, and 56% had 3 vaccine doses prior to infection. Logistic regression found higher mortality (p = 0.001) and hospitalization (p = 0.016) rates for older recipients, while those with 3 or more vaccine doses had lower mortality (p = 0.039) and hospitalization (p = 0.008) rates. Chronic kidney disease (CKD) increased risk of hospitalization (p < 0.001). Adjusting for the date when the Omicron variant became locally predominant, the protective effect from 3 or more vaccine doses declined to an OR (95% CI) of 0.58 (0.15–2.23), p = 0.39.ConclusionsThree or more COVID-19 vaccine doses could decrease mortality for LT recipients, particularly older recipients and those with CKD. These individuals may benefit from vaccination and other interventions. |
| format | Article |
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| institution | Kabale University |
| issn | 2813-2440 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Transplantation |
| spelling | doaj-art-3db0c204a07840958f82ab7a0faa36002025-01-09T06:10:33ZengFrontiers Media S.A.Frontiers in Transplantation2813-24402025-01-01310.3389/frtra.2024.15159641515964Clinical outcomes of COVID-19 infection in liver transplant recipients based on vaccination statusVinathi Polamraju0Neeta Vachharajani1Brian F. Gage2Jeffrey S. Crippin3William C. Chapman4Department of Medicine, Washington University School of Medicine, St. Louis, MO, United StatesSection of Transplant Surgery, Washington University School of Medicine, St. Louis, MO, United StatesDepartment of Medicine, Washington University School of Medicine, St. Louis, MO, United StatesDepartment of Medicine, Washington University School of Medicine, St. Louis, MO, United StatesSection of Transplant Surgery, Washington University School of Medicine, St. Louis, MO, United StatesBackgroundCOVID-19 disease burden has been mitigated by vaccination; however, concerns persist regarding weakened immune responses in liver transplant (LT) recipients. This study investigates COVID-19 outcomes in LT recipients based on vaccination status.MethodsThis single-center retrospective study identified LT recipients with PCR-confirmed COVID-19 infection from 03/01/2020 to 07/31/2023. Logistic regression analyses were conducted, adjusting for age, race, co-morbidities, number of immunosuppressive agents, and infection date.ResultsOf 1,787 registered LT recipients, 361 had confirmed COVID-19 infection. Of those, 136 were unvaccinated and 225 were vaccinated. 13% had 1 vaccine dose, 31% had 2 vaccine doses, and 56% had 3 vaccine doses prior to infection. Logistic regression found higher mortality (p = 0.001) and hospitalization (p = 0.016) rates for older recipients, while those with 3 or more vaccine doses had lower mortality (p = 0.039) and hospitalization (p = 0.008) rates. Chronic kidney disease (CKD) increased risk of hospitalization (p < 0.001). Adjusting for the date when the Omicron variant became locally predominant, the protective effect from 3 or more vaccine doses declined to an OR (95% CI) of 0.58 (0.15–2.23), p = 0.39.ConclusionsThree or more COVID-19 vaccine doses could decrease mortality for LT recipients, particularly older recipients and those with CKD. These individuals may benefit from vaccination and other interventions.https://www.frontiersin.org/articles/10.3389/frtra.2024.1515964/fullliver transplantationCOVID-19vaccinationdisease severityrisk factors |
| spellingShingle | Vinathi Polamraju Neeta Vachharajani Brian F. Gage Jeffrey S. Crippin William C. Chapman Clinical outcomes of COVID-19 infection in liver transplant recipients based on vaccination status Frontiers in Transplantation liver transplantation COVID-19 vaccination disease severity risk factors |
| title | Clinical outcomes of COVID-19 infection in liver transplant recipients based on vaccination status |
| title_full | Clinical outcomes of COVID-19 infection in liver transplant recipients based on vaccination status |
| title_fullStr | Clinical outcomes of COVID-19 infection in liver transplant recipients based on vaccination status |
| title_full_unstemmed | Clinical outcomes of COVID-19 infection in liver transplant recipients based on vaccination status |
| title_short | Clinical outcomes of COVID-19 infection in liver transplant recipients based on vaccination status |
| title_sort | clinical outcomes of covid 19 infection in liver transplant recipients based on vaccination status |
| topic | liver transplantation COVID-19 vaccination disease severity risk factors |
| url | https://www.frontiersin.org/articles/10.3389/frtra.2024.1515964/full |
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