Inactivated vaccines reduce the risk of liver function abnormality in NAFLD patients with COVID-19: a multi-center retrospective studyResearch in context
Summary: Background: Abnormal liver function was frequently observed in nonalcoholic fatty liver disease (NAFLD) patients infected with SARS-CoV-2. Our aim was to explore the effect of SARS-CoV-2 inactivated vaccines on liver function abnormality among NAFLD patients with COVID-19. Methods: The mul...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-01-01
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| Series: | EBioMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352396423004784 |
| _version_ | 1797391823758426112 |
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| author | Zhixue Chen Wenqing Tang Nana Feng Minzhi Lv Fansheng Meng Huibin Wu Yitong Zhao Huajie Xu Yuxin Dai Jindan Xue Jingya Wang Anjun Xu Beilin Zhang Dejie Chu Yuqin Li Dejun Wu Ling Dong Si Zhang Ruyi Xue |
| author_facet | Zhixue Chen Wenqing Tang Nana Feng Minzhi Lv Fansheng Meng Huibin Wu Yitong Zhao Huajie Xu Yuxin Dai Jindan Xue Jingya Wang Anjun Xu Beilin Zhang Dejie Chu Yuqin Li Dejun Wu Ling Dong Si Zhang Ruyi Xue |
| author_sort | Zhixue Chen |
| collection | DOAJ |
| description | Summary: Background: Abnormal liver function was frequently observed in nonalcoholic fatty liver disease (NAFLD) patients infected with SARS-CoV-2. Our aim was to explore the effect of SARS-CoV-2 inactivated vaccines on liver function abnormality among NAFLD patients with COVID-19. Methods: The multi-center retrospective cohort included 517 NAFLD patients with COVID-19 from 1 April to 30 June 2022. Participants who received 2 doses of the vaccine (n = 274) were propensity score matched (PSM) with 243 unvaccinated controls. The primary outcome was liver function abnormality and the secondary outcome was viral shedding duration. Logistic and Cox regression models were used to calculate the odds ratio (OR) and hazard ratio (HR) for the outcomes. Sensitivity analysis was conducted to assess robustness. Findings: PSM identified 171 pairs of vaccinated and unvaccinated patients. Liver function abnormality was less frequent in the vaccinated group (adjusted OR, 0.556 [95% CI (confidence interval), 0.356–0.869], p = 0.010). Additionally, the vaccinated group demonstrated a lower incidence of abnormal bilirubin levels (total bilirubin: adjusted OR, 0.223 [95% CI, 0.072–0.690], p = 0.009; direct bilirubin: adjusted OR, 0.175 [95% CI, 0.080–0.384], p < 0.001) and shorter viral shedding duration (adjusted HR, 0.798 [95% CI, 0.641–0.994], p = 0.044) than the unvaccinated group. Further subgroup analysis revealed similar results, while the sensitivity analyses indicated consistent findings. Interpretation: SARS-CoV-2 vaccination in patients with NAFLD may reduce the risk of liver dysfunction during COVID-19. Furthermore, vaccination demonstrated beneficial effects on viral shedding in the NAFLD population. Funding: 23XD1422700, Tszb2023-01, Zdzk2020-10, Zdxk2020-01, 2308085J27 and JLY20180124. |
| first_indexed | 2024-03-08T23:38:17Z |
| format | Article |
| id | doaj.art-f7732c7c2e66401abd001c092456a817 |
| institution | Directory Open Access Journal |
| issn | 2352-3964 |
| language | English |
| last_indexed | 2024-03-08T23:38:17Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EBioMedicine |
| spelling | doaj.art-f7732c7c2e66401abd001c092456a8172023-12-14T05:23:11ZengElsevierEBioMedicine2352-39642024-01-0199104912Inactivated vaccines reduce the risk of liver function abnormality in NAFLD patients with COVID-19: a multi-center retrospective studyResearch in contextZhixue Chen0Wenqing Tang1Nana Feng2Minzhi Lv3Fansheng Meng4Huibin Wu5Yitong Zhao6Huajie Xu7Yuxin Dai8Jindan Xue9Jingya Wang10Anjun Xu11Beilin Zhang12Dejie Chu13Yuqin Li14Dejun Wu15Ling Dong16Si Zhang17Ruyi Xue18Department of Gastroenterology and Hepatology, Shanghai Institute of Liver Diseases, Zhongshan Hospital, Fudan University, Shanghai, 200032, ChinaDepartment of Gastroenterology and Hepatology, Shanghai Institute of Liver Diseases, Zhongshan Hospital, Fudan University, Shanghai, 200032, ChinaDepartment of Respiratory and Critical Medicine, Shanghai Eighth People’s Hospital Affiliated to Jiang Su University, Shanghai, 200030, ChinaClinical Research Unit, Department of Biostatistics, Zhongshan Hospital, Fudan University, Shanghai, 200032, China; Department of Biostatistics, Clinical Research Unit, Key Laboratory of Public Health Safety of Ministry of Education, Key Laboratory for Health Technology Assessment, National Commission of Health, School of Public Health, Center of Evidence-Based Medicine, Fudan University, Shanghai, 200032, ChinaLiver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032, ChinaDepartment of Gastroenterology and Hepatology, Shanghai Institute of Liver Diseases, Zhongshan Hospital, Fudan University, Shanghai, 200032, ChinaSchool of Medicine, Anhui University of Science and Technology, Anhui, 232000, ChinaDepartment of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Fudan University, Shanghai, 200032, ChinaNHC Key Laboratory of Glycoconjugate Research, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, ChinaSchool of Medicine, Anhui University of Science and Technology, Anhui, 232000, ChinaDepartment of Biochemistry and Molecular Biology, Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, ChinaDepartment of General Surgery, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, 201399, ChinaDepartment of Gastroenterology and Hepatology, Shanghai Baoshan District Wusong Central Hospital (Zhongshan Hospital Wusong Branch, Fudan University), Shanghai, 200940, ChinaDepartment of Respiratory and Critical Medicine, Shanghai Eighth People’s Hospital Affiliated to Jiang Su University, Shanghai, 200030, ChinaDepartment of Gastroenterology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, 201399, ChinaDepartment of General Surgery, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, 201399, China; Department of Gastrointestinal Surgery, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, 201399, China; Corresponding author. Department of General Surgery, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, 201399, China.Department of Gastroenterology and Hepatology, Shanghai Institute of Liver Diseases, Zhongshan Hospital, Fudan University, Shanghai, 200032, China; Corresponding author. Department of Gastroenterology and Hepatology, Shanghai Institute of Liver Diseases, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.NHC Key Laboratory of Glycoconjugate Research, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, China; Corresponding author. NHC Key Laboratory of Glycoconjugate Research, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, China.Department of Gastroenterology and Hepatology, Shanghai Institute of Liver Diseases, Zhongshan Hospital, Fudan University, Shanghai, 200032, China; Department of Gastroenterology and Hepatology, Shanghai Baoshan District Wusong Central Hospital (Zhongshan Hospital Wusong Branch, Fudan University), Shanghai, 200940, China; Corresponding author. Department of Gastroenterology and Hepatology, Shanghai Institute of Liver Diseases, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.Summary: Background: Abnormal liver function was frequently observed in nonalcoholic fatty liver disease (NAFLD) patients infected with SARS-CoV-2. Our aim was to explore the effect of SARS-CoV-2 inactivated vaccines on liver function abnormality among NAFLD patients with COVID-19. Methods: The multi-center retrospective cohort included 517 NAFLD patients with COVID-19 from 1 April to 30 June 2022. Participants who received 2 doses of the vaccine (n = 274) were propensity score matched (PSM) with 243 unvaccinated controls. The primary outcome was liver function abnormality and the secondary outcome was viral shedding duration. Logistic and Cox regression models were used to calculate the odds ratio (OR) and hazard ratio (HR) for the outcomes. Sensitivity analysis was conducted to assess robustness. Findings: PSM identified 171 pairs of vaccinated and unvaccinated patients. Liver function abnormality was less frequent in the vaccinated group (adjusted OR, 0.556 [95% CI (confidence interval), 0.356–0.869], p = 0.010). Additionally, the vaccinated group demonstrated a lower incidence of abnormal bilirubin levels (total bilirubin: adjusted OR, 0.223 [95% CI, 0.072–0.690], p = 0.009; direct bilirubin: adjusted OR, 0.175 [95% CI, 0.080–0.384], p < 0.001) and shorter viral shedding duration (adjusted HR, 0.798 [95% CI, 0.641–0.994], p = 0.044) than the unvaccinated group. Further subgroup analysis revealed similar results, while the sensitivity analyses indicated consistent findings. Interpretation: SARS-CoV-2 vaccination in patients with NAFLD may reduce the risk of liver dysfunction during COVID-19. Furthermore, vaccination demonstrated beneficial effects on viral shedding in the NAFLD population. Funding: 23XD1422700, Tszb2023-01, Zdzk2020-10, Zdxk2020-01, 2308085J27 and JLY20180124.http://www.sciencedirect.com/science/article/pii/S2352396423004784COVID-19Nonalcoholic fatty liver diseaseInactivated SARS-CoV-2 vaccineLiver function abnormalityDirect bilirubin |
| spellingShingle | Zhixue Chen Wenqing Tang Nana Feng Minzhi Lv Fansheng Meng Huibin Wu Yitong Zhao Huajie Xu Yuxin Dai Jindan Xue Jingya Wang Anjun Xu Beilin Zhang Dejie Chu Yuqin Li Dejun Wu Ling Dong Si Zhang Ruyi Xue Inactivated vaccines reduce the risk of liver function abnormality in NAFLD patients with COVID-19: a multi-center retrospective studyResearch in context EBioMedicine COVID-19 Nonalcoholic fatty liver disease Inactivated SARS-CoV-2 vaccine Liver function abnormality Direct bilirubin |
| title | Inactivated vaccines reduce the risk of liver function abnormality in NAFLD patients with COVID-19: a multi-center retrospective studyResearch in context |
| title_full | Inactivated vaccines reduce the risk of liver function abnormality in NAFLD patients with COVID-19: a multi-center retrospective studyResearch in context |
| title_fullStr | Inactivated vaccines reduce the risk of liver function abnormality in NAFLD patients with COVID-19: a multi-center retrospective studyResearch in context |
| title_full_unstemmed | Inactivated vaccines reduce the risk of liver function abnormality in NAFLD patients with COVID-19: a multi-center retrospective studyResearch in context |
| title_short | Inactivated vaccines reduce the risk of liver function abnormality in NAFLD patients with COVID-19: a multi-center retrospective studyResearch in context |
| title_sort | inactivated vaccines reduce the risk of liver function abnormality in nafld patients with covid 19 a multi center retrospective studyresearch in context |
| topic | COVID-19 Nonalcoholic fatty liver disease Inactivated SARS-CoV-2 vaccine Liver function abnormality Direct bilirubin |
| url | http://www.sciencedirect.com/science/article/pii/S2352396423004784 |
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