Immune Response and Risk of Decompensation following SARS-CoV-2 Infection in Outpatients with Advanced Chronic Liver Disease
Brujats Rubirola, Anna (Institut de Recerca Sant Pau)
Huerta, Anna (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Osuna Gómez, Rubén (Institut de Recerca Sant Pau)
Guinart Cuadra, Albert (Institut de Recerca Sant Pau)
Ferrero-Gregori, Andreu (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Pujol Camps, Clàudia (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Soriano, German (Institut de Recerca Sant Pau)
Poca Sans, Maria (Institut de Recerca Sant Pau)
Fajardo Ordoñez, Javier (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Escorsell, Àngels (Institut de Recerca Sant Pau)
Gallego Moya, Adolfo (Institut de Recerca Sant Pau)
Vidal, Silvia (Institut de Recerca Sant Pau)
Villanueva, Càndid (Institut de Recerca Sant Pau)
Alvarado-Tapias, Edilmar (Institut de Recerca Sant Pau)
Universitat Autònoma de Barcelona

Data:	2024
Resum:	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.
Ajuts:	Instituto de Salud Carlos III JR20/00047 Instituto de Salud Carlos III PI21/01995
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Advanced chronic liver disease (ACLD) ; Anti-Spike 1 immunoglobulin G ; Decompensation ; Immune response ; SARS-CoV-2 infection
Publicat a:	International journal of molecular sciences, Vol. 25 Núm. 15 (august 2024) , p. 8302, ISSN 1422-0067

DOI: 10.3390/ijms25158302
PMID: 39125872

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