Guanglin Xiao, Taiyu He, Biqiong Zhang, Ziqiao Yang, Ning Ling, Min Chen, Dazhi Zhang, Peng Hu, Gaoli Zhang, Mingli Peng, Dachuan Cai, Hong Ren
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Compared to healthy controls (HCs), patients with CLD had a higher incidence of mild adverse events (RR = 1.60, <i>p</i> < 0.001), while the incidence of severe adverse events was similar (RR = 1.08, <i>p</i> = 0.92). Seropositivity rates of three antibodies in patients were lower than in HCs [neutralizing antibody (RR = 0.86, <i>p</i> = 0.002), anti-spike antibody (RR = 0.97, <i>p</i> = 0.06) and anti-receptor binding domain antibody (RR = 0.95, <i>p</i> = 0.04)]. Compared to unvaccinated patients, vaccinated patients had lower rates of SARS-CoV-2 infection, hospitalization and death (<i>p</i> ≤ 0.05).</p><p><strong>Conclusion: </strong>SARS-CoV-2 vaccines showed good safety and efficacy in CLD patients, but antibody response appeared to be decreased. 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引用次数: 0
摘要
目的：本综述旨在评估SARS-CoV-2疫苗在慢性肝病（CLD）患者中的安全性和有效性。方法：检索2020 - 2024年Cochrane中央对照试验注册库、PubMed、Embase和Web of Science。根据系统评价和荟萃分析指南的首选报告项目提取数据。采用随机效应模型（I2≥50%）或固定效应模型（I2 < 50%）。结果：本综述纳入了29项研究。与健康对照组（HCs）相比，CLD患者轻度不良事件发生率较高（RR = 1.60, p < 0.001），严重不良事件发生率相似（RR = 1.08, p = 0.92）。患者3种抗体的血清阳性率均低于hc[中和抗体（RR = 0.86, p = 0.002）、抗尖峰抗体（RR = 0.97, p = 0.06）和抗受体结合域抗体（RR = 0.95, p = 0.04）]。与未接种疫苗的患者相比，接种疫苗的患者SARS-CoV-2感染率、住院率和死亡率均低于未接种疫苗的患者（p≤0.05）。结论：SARS-CoV-2疫苗在CLD患者中具有良好的安全性和有效性，但抗体反应有所下降。因此，应优先在这一脆弱人群中接种SARS-CoV-2疫苗和加强剂。
Safety and Efficacy of SARS-CoV-2 Vaccines in Patients With Chronic Liver Diseases: A Systematic Review and Meta-Analysis.
Objectives: This review aimed to assess the safety and efficacy of SARS-CoV-2 vaccines in patients with chronic liver disease (CLD).
Methods: Cochrane Central Register of Controlled Trials, PubMed, Embase, and Web of Science were searched from 2020 to 2024. Data was extracted following Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. The random-effects model (when I2 ≥ 50%) or fixed effect model (I2 < 50%) was used.
Results: 29 studies were included in this review. Compared to healthy controls (HCs), patients with CLD had a higher incidence of mild adverse events (RR = 1.60, p < 0.001), while the incidence of severe adverse events was similar (RR = 1.08, p = 0.92). Seropositivity rates of three antibodies in patients were lower than in HCs [neutralizing antibody (RR = 0.86, p = 0.002), anti-spike antibody (RR = 0.97, p = 0.06) and anti-receptor binding domain antibody (RR = 0.95, p = 0.04)]. Compared to unvaccinated patients, vaccinated patients had lower rates of SARS-CoV-2 infection, hospitalization and death (p ≤ 0.05).
Conclusion: SARS-CoV-2 vaccines showed good safety and efficacy in CLD patients, but antibody response appeared to be decreased. Therefore, SARS-CoV-2 vaccines and booster doses should be given priority in this vulnerable population.
期刊介绍：
The International Journal of Public Health publishes scientific articles relevant to global public health, from different countries and cultures, and assembles them into issues that raise awareness and understanding of public health problems and solutions. The Journal welcomes submissions of original research, critical and relevant reviews, methodological papers and manuscripts that emphasize theoretical content. IJPH sometimes publishes commentaries and opinions. Special issues highlight key areas of current research. The Editorial Board''s mission is to provide a thoughtful forum for contemporary issues and challenges in global public health research and practice.
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