Impact of SARS-CoV-2 vaccination in patients with vascular liver diseases: Observations from a VALDIG multicenter study

Abstract

Background and AimsPatients with vascular liver diseases(VLD) are at higher risk for both severe courses of COVID-19 disease and thromboembolic events. The impact of the SARS-CoV-2 vaccination in VLD patients has not been described and represent the aim of our study. MethodsInternational multicenter prospective observational study in patients with VLD analyzing the incidence of COVID-19 infection after vaccination, severity of side effects, occurrence of thromboembolic events and hepatic decompensation. In a subgroup of patients, the humoral and cellular responses to vaccination were also analyzed. Results898 patients from 14 European centers part of the VALDIG network were included, 872(97.1%) patients received two vaccine doses (fully vaccinated), and 674(75.1%) three doses.Of the total cohort, 151/898 had a COVID-19 infection prior to vaccination, of which 9/151(5.9%) were re-infected. Of the previously 747/898 patients who were not previously infected, 11.2%(84/747) were diagnosed with a COVID-19 infection during the study period.Two infected patients required ICU admission and infection was fatal in two fully vaccinated patients. Main adverse effects were reported in around 40% of patients, being local side effects the most frequent.During the study period, 31(3.5%) patients had thromboembolic events and 21(2.3%) hepatic decompensations. No vaccine-induced-thrombocytopenia (VITT) case was reported.Vaccine immunogenicity was assessed in 36 patients; seroconversion reached 100% and IFNy-T cell responses significant increased post two mRNA-1273 vaccine doses. ConclusionPatients with VLD seems to have a preserved immune response to SARS-CoV-2 vaccination, which appears to be safe and effective in preventing severe COVID-19 infection. Our study cannot definitively establish a direct link between vaccination and thrombotic events, however the contribution of vaccination as a cofactor in VLD remains to be elucidated.