Immune‐mediated liver injury following COVID‐19 vaccination: A systematic review

Roy, Akash; Verma, Nipun; Singh, Surender; Pradhan, Pranita; Taneja, Sunil; Singh, Meenu

doi:10.1002/hep4.1979

Cited by 25 publications

(30 citation statements)

References 44 publications

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“…Nevertheless in those cases, pre-existing comorbidities was common as 69.6% such as liver disease. The mortality rate due to live disorders was reported 4.3% (62).…”

Section: Discussionmentioning

confidence: 99%

A Landscape on Disorders Following Different COVID-19 Vaccination: A Systematic Review of Iranian Case Reports

Larijani¹,

Doroud²,

Banifazl³

et al. 2023

Preprint

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Vaccination against SARS-CoV-2 has significantly contributed to the recent pandemic control. COVID-19 vaccines are available with different platforms and the primary clinical trials results presented acceptable safety profile of the approved vaccines. Nevertheless, the long-term assessment of the adverse events or rare conditions need to be investigated. The present systematic review, aimed at classification of Iranian case reports following COVID-19 immunization. To achieve this goal, the related published case reports were explored via PubMed, Web of Science and Google scholar according to PRISMA guideline and available up to 14th Dec, 2022. Out of 437 explored studies, the relevant data were fully investigated which totally led to 40 studies including 64 case reports with a new onset of a problem. The cases were then classified according to the various items such as the type of adverse event manifestations and COVID-19 vaccine. The reported COVID-19 vaccines in the studied cases included Sinopharm, AstraZeneca, and COVAXIN. The results showed that the adverse events presented in 8 different categories from which cutaneous problems accounted as the most prevalent manifestations (43.7%) in which rare diseases were also screened such as Steven-Johnson syndrome, Morphea and Toxic Epidermal Necrolysis. Notably, almost 60% of the cases had no comorbidities. Moreover, the obtained data revealed nearly half of the incidences occurred after the first dose of injection and the mean duration of improvement after the symptom onset was 18.72±24.69 days. 73% of all the cases were either significantly improved or fully recovered. Although the advantages of COVID-19 vaccination is undoubtedly significant, the high risk individuals including those with a history of serious disease or comorbidities immunodeficiency conditions should be vaccinated with the utmost caution.

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“…Nevertheless in those cases, pre-existing comorbidities was common as 69.6% such as liver disease. The mortality rate due to live disorders was reported 4.3% (62).…”

Section: Discussionmentioning

confidence: 99%

A Landscape on Disorders Following Different COVID-19 Vaccination: A Systematic Review of Iranian Case Reports

Larijani¹,

Doroud²,

Banifazl³

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Eosinophils, which are often associated with drug-induced liver injury, were observed in the liver biopsies of eleven cases (82,83). This raises the question whether COVID-19 vaccinations incite a phenomenon resembling drug-induced-AIH (DI-AIH) or trigger idiopathic AIH (84). The literature suggests a significant overlap between idiopathic AIH and DI-AIH cases.…”

Section: Discussionmentioning

confidence: 99%

“…The reliability of case reports fails to confirm whether the relationship between AIH and vaccines is casual or causal. The concurrent use of drugs (statins and antibiotics) that may trigger autoimmunity adds further confoundment and raises questions on the causality (84). Causality assessment requires further investigation by long-term follow-ups and future animal experiments.…”

Section: Discussionmentioning

confidence: 99%

Autoimmune hepatitis after COVID-19 vaccination

Zheng

Zhang

et al. 2022

Front. Immunol.

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Vaccination is one of the most vigorous ways to intervene in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Cases of autoimmune hepatitis (AIH) after coronavirus disease (COVID-19) vaccination have been increasingly reported. Twenty-seven cases of AIH are summarized in this study, providing emerging evidence of autoimmune reactions in response to various COVID-19 vaccines, including in patients with special disease backgrounds such as primary sclerosing cholangitis (PSC), liver transplantation, and previous hepatitis C virus (HCV) treatment. Molecular mimicry, adjuvants, epitope spreading, bystander activation, X chromosome, and sceptical hepatotropism of SARS-CoV-2 may account for, to some extent, such autoimmune phenomena. Immunosuppressive corticosteroids perform well with or without azathioprine in such post-COVID-19-vaccination AIH. However, determination of the exact mechanism and establishment of causality require further confirmation.

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“…Vaccine was well tolerated by all patients and graft function was unaffected. During the follow-up, liver biochemistry was normal in 87.5% cases and immune-mediated liver injury following vaccination was not suspected ( 10 ).…”

Section: Discussionmentioning

confidence: 99%

Humoral and cellular immune responses to Pfizer-BioNTech BNT162b2 SARS-CoV-2 vaccine in adolescents with liver transplantation: Single center experience

et al. 2022

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BackgroundImmune responses to vaccines against severe acute respiratory syndrome (SARS)-coronavirus (CoV)-2 are variable. In the absence of disease, youngsters are expected to better react to vaccines than adults. Nevertheless, chronic immunosuppression in transplant recipients may impair their capability to generate protection. We aim to explore immune responses after BNT162b2 SARS-CoV-2 vaccination in our cohort of young liver-transplanted patients.MethodsA prospective study of adolescent liver-transplanted patients (n=33) in the long-term follow-up was performed. Immune responses after receiving Pfizer-BioNTech BNT162b2 vaccine were analyzed at two time-points: baseline and 30 days after the second dose. Humoral responses were measured by fluoroenzyme-immunoassay and T-cell responses by interferon-γ-release assay. Post-vaccine coronavirus disease (COVID-19) events were recorded by a survey.ResultsPre-vaccine SARS-CoV-2-specific antibodies were undetectable in 27/32 (84.4%), negative/indeterminate in 3/32 (9.4%) and positive in 2/32 (6.3%) patients. Cellular responses at baseline were negative in 12/18 (66.6%), positive in 3/18 (16.6%) and indeterminate in 3/18 (16.6%) recipients. None of the baseline positives recalled any symptoms. Post-vaccine antibodies were detected in all patients and 92.6% showed levels >816 BAU/mL. Twenty (71.4%) recipients had positive T-cell responses. Regarding post-vaccine SARS-Cov-2 infection, 10 (30.3%) patients reported COVID-19 without hospitalization and 21 (63.6%) did not notify any infection. Negative and positive cell-response groups after vaccination showed statistically significant differences regarding COVID-19 cases (62.5% vs 22.2%, respectively; p=0.046).ConclusionsAdolescents and young adults with liver transplantation responded to SARS-Cov-2 vaccine, generating both humoral and cellular responses. Recipients developing cellular responses after vaccination had a lower incidence of COVID-19.

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Immune‐mediated liver injury following COVID‐19 vaccination: A systematic review

Cited by 25 publications

References 44 publications

A Landscape on Disorders Following Different COVID-19 Vaccination: A Systematic Review of Iranian Case Reports

A Landscape on Disorders Following Different COVID-19 Vaccination: A Systematic Review of Iranian Case Reports

Autoimmune hepatitis after COVID-19 vaccination

Humoral and cellular immune responses to Pfizer-BioNTech BNT162b2 SARS-CoV-2 vaccine in adolescents with liver transplantation: Single center experience

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