Inactivated SARS-CoV-2 booster vaccine enhanced immune responses in patients with chronic liver diseases

Yongmei Liu; Jianhua Lu; Haoting Zhan; Wenfang Yuan; Xiaomeng Li; Haiyan Kang; Haolong Li; Yongliang Chen; Linlin Cheng; Xingli Sun; Haojie Zheng; Wei Wang; Erhei Dai; Yongzhe Li

doi:10.1016/j.virs.2023.07.005

October 2023

Citation: Yongmei Liu, Jianhua Lu, Haoting Zhan, Wenfang Yuan, Xiaomeng Li, Haiyan Kang, Haolong Li, Yongliang Chen, Linlin Cheng, Xingli Sun, Haojie Zheng, Wei Wang, Erhei Dai, Yongzhe Li. Inactivated SARS-CoV-2 booster vaccine enhanced immune responses in patients with chronic liver diseases .VIROLOGICA SINICA, 2023, 38(5) : 723-734. http://dx.doi.org/10.1016/j.virs.2023.07.005

Inactivated SARS-CoV-2 booster vaccine enhanced immune responses in patients with chronic liver diseases

Yongmei Liu ^a ,
Jianhua Lu ^c ,
Haoting Zhan ^a ,
Wenfang Yuan ^b ,
Xiaomeng Li ^a,d ,
Haiyan Kang ^b ,
Haolong Li ^a ,
Yongliang Chen ^b ,
Linlin Cheng ^a ,
Xingli Sun ^b ,
Haojie Zheng ^b ,
Wei Wang ^b ,
Erhei Dai ^{b
,,} ,
Yongzhe Li ^{a
,,}

a. Department of Clinical Laboratory, State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China;
b. Division of Liver Diseases, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, 050021, China;
c. Department of Clinical Laboratory, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, 050021, China;
d. Department of Clinical Laboratory, Peking University People's Hospital, Beijing, 100035, China

Corresponding author: Erhei Dai, daieh2008@126.com
Yongzhe Li, yongzhelipumch@126.com
Received Date: 20 April 2023
Accepted Date: 19 July 2023
Available online: 22 July 2023

Abstract

Chronic liver disease (CLD) entails elevated risk of COVID-19 severity and mortality. The effectiveness of the booster dose of inactivated SARS-CoV-2 vaccine in stimulating antibody response in CLD patients is unclear. Therefore, we conducted a cross-sectional study involving 237 adult CLD patients and 170 healthy controls (HC) to analyze neutralizing antibodies (NAbs) against SARS-CoV-2 prototype and BA.4/5 variant, anti-receptor binding domain (RBD) IgG, and total anti-SARS-CoV-2 antibodies. Serum levels of the total anti-SARS-CoV-2 antibodies, anti-RBD IgG and inhibition efficacy of NAbs were significantly elevated in CLD patients after the booster dose compared with the pre-booster dose, but were relatively lower than those of HCs. Induced humoral responses decreased over time after booster vaccination. The neutralization efficiency of the serum against BA.4/5 increased but remained below the inhibition threshold. All four SARS-CoV-2 antibodies, including total anti-SARS-CoV-2 antibodies, anti-RBD IgG and NAbs against prototype and BA.4/5, were lower in patients with severe CLD than those with non-severe CLD. After booster shot, age and time after the last vaccine were the risk factors for seropositivity of NAb against BA.4/5 in CLD patients. Additionally, white blood cell counts and hepatitis B core antibodies were the protective factors, and severe liver disease was the risk factor associated with seropositivity of total anti-SARS-CoV-2 antibodies. Overall, our data uncovered that antibody responses were improved in CLD patients and peaked at 120 days after the booster vaccines. All antibodies excepting total anti-SARS-CoV-2 antibodies declined after peak. CLD patients exhibited impaired immunologic responses to vaccination and weakened NAbs against BA.4/5, which hindered the protective effect of the booster shot against Omicron prevalence. Cellular immune responses should be further evaluated to determine the optimal vaccine regimen for CLD patients.
- Chronic liver disease (CLD)
- , SARS-CoV-2 inactivated vaccines
- , Booster vaccination
- , Antibody response
- , Immune response

Electronic Supplementary Material

10.1016j.virs.2023.07.005-ESM.docx
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