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- Title
Immune Response and Risk of Decompensation following SARS-CoV-2 Infection in Outpatients with Advanced Chronic Liver Disease.
- Authors
Brujats, Anna; Huerta, Anna; Osuna-Gómez, Rubén; Guinart-Cuadra, Albert; Ferrero-Gregori, Andreu; Pujol, Clàudia; Soriano, German; Poca, Maria; Fajardo, Javier; Escorsell, Angels; Gallego, Adolfo; Vidal, Silvia; Villanueva, Càndid; Alvarado-Tapias, Edilmar
- Abstract
Advanced chronic liver disease (ACLD) is associated with a wide spectrum of immune dysfunction. The clinical impact of SARS-CoV-2 on the development of decompensation and immune response in unvaccinated outpatients has not as yet been clearly defined. This study aimed to evaluate the clinical and immunological impact of SARS-CoV-2 on outpatients with ACLD. This is an observational case–control study, in which ACLD outpatients were included prospectively and consecutively and classified into two groups: SARS-CoV-2 infected and non-infected. Patients' baseline characteristics and infection data were collected and analyzed. Immunoglobulin G (IgG) levels against Spike 1 were evaluated. The primary endpoint was risk of liver decompensation during follow-up, assessed after propensity score matching and adjusted by Cox regression. Between October 2020 and July 2021, ACLD outpatients (n = 580) were identified, and 174 patients with clinical follow-up were included. SARS-CoV-2 infection incidence was 7.6% (n = 44). Risk of liver decompensation was significantly higher after infection (HR = 2.43 [1.01–5.86], p = 0.048) vs. non-infection. The time of IgG evaluation was similar in all patients (n = 74); IgG concentrations were significantly higher in compensated vs. decompensated patients (1.02 ± 0.35 pg/mL vs. 0.34 ± 0.16 pg/mL, p < 0.0001) and correlated with hemoglobin levels. The dysregulation of the innate immune response in patients with decompensated liver disease increased the risk of further decompensation following SARS-CoV-2, mainly due to a worsening of ascites.
- Subjects
PROPENSITY score matching; IMMUNOGLOBULIN G; IMMUNE response; LIVER diseases; SARS-CoV-2
- Publication
International Journal of Molecular Sciences, 2024, Vol 25, Issue 15, p8302
- ISSN
1661-6596
- Publication type
Article
- DOI
10.3390/ijms25158302