Analysis of neutralizing antibody to  COVID-19 vaccine  in hospitalized patients with liver dysfunction

Abstract

Background: To evaluate the level of neutralizing antibodies(NAbs) after COVID-19 vaccination in patients suffered from liver dysfunction.Methods: In this cross-sectional study with longitudinal follow-up , a total of 137 patients and 134 healthy volunteers with full-course COVID-19 vaccination for more than 1 month were enrolled. Data of clinical characteristics , dates after vaccination and the types of vaccine were collected. Blood samples were collected for NAbs test when the patient was hospitalized, and some collected second time after treatment. Results: Both seropositivity and mean titer of NAbs in patients was significantly lower than that in healthy control(65.7% vs 80.60%; 3.954 vs 4.944 log2AU/ml ). The decrease of antibody titer in patients was significantly faster than that in healthy controls（-2.642 vs -0.9654 AU/ml per day). In multiple logistic regression analysis, more severe liver damage (odds ratio (OR): 0.30; 95% confidence interval (95%CI): 0.12–0.71; p=0.0067) and male (OR: 0.17; 95%CI: 0.06–0.46; p=0.0005)were significantly associated with reduction of the probability of NAbs seropositivity. Chronic liver status(β =−1.45; 95% CI: −2.13 to −0.76; p<0.0001) and male sex (β =−1.18; 95% CI: −1.73 to −0.64; p<0.0001) were significantly associated with higher NAbs titers. In 26 patients with liver failure, both the antibody seropositivity and titer did not decrease, but increased(before 53.8% vs after 84.6%; 3.553 vs 4.321 log2AU/ml)after artificial liver plasmapheresis.Conclusions: Compared with healthy people, the seropositivity and titer of NAbs after COVID-19 vaccination in patients with liver dysfunction were lower and the titer decreased faster. Male, severe liver injury and chronic liver status have increased risk of poor antibody responses, and artificial liver treatment does not reduce NAbs titers in patients with liver failure.