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COVID-19 vaccine effectiveness and community prevalence of Alpha, Delta and Omicron variants in patients with cirrhosis
  1. Binu V John1,2,
  2. Dustin R Bastaich3,
  3. Raphaella D Ferreira2,
  4. Akash Doshi4,
  5. Tamar H Taddei5,
  6. David E Kaplan6,
  7. Seth Spector7,8,
  8. Yangyang Deng3,
  9. Bassam Dahman3
  1. 1 Gastroenterology and Hepatology, University of Miami, Miami, Florida, USA
  2. 2 Gastroenterology and Hepatology, Miami VA Healthcare System, Miami, Florida, USA
  3. 3 Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia, USA
  4. 4 Miller School of Medicine, University of Miami, Miami, Florida, USA
  5. 5 Medicine, VA Connecticut Health System West Haven Campus, West Haven, Connecticut, USA
  6. 6 Gastroenterology and Hepatology, Hospital of the Inversity of Pennsylvania, Philadelphia, Pennsylvania, USA
  7. 7 Department of Surgery, University of Miami, Coral Gables, Florida, USA
  8. 8 Department of Surgery, Bruce W Carter Department of Veterans Affairs Medical Center, Miami, Florida, USA
  1. Correspondence to Dr Binu V John, Gastroenterology and Hepatology, University of Miami, Miami, Florida, USA; binu.john{at}

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We read with interest about the prognostic significance of liver function abnormalities in SARS-CoV-2 infection.1 2 Although patients with underlying cirrhosis have an increased risk of death following COVID-19, mRNA vaccine administration is associated with an excellent reduction in mortality.3 4 We aimed to determine the association of the prevalence of the Alpha, Delta and Omicron variants and effectiveness of the BNT162b2 or 1273-mRNA vaccines among participants with cirrhosis.

We performed a test-negative case–control study of participants with cirrhosis in the Veterans Outcomes and Costs Associated with Liver disease cohort, who had a SARS-CoV-2 PCR between 1 February 2021 and 21 January 2022.5–7

Participants with a positive PCR were considered as cases, and others, as controls. Propensity score (PS) matching was used to match cases and controls, with PS of being a case derived from a logistic regression that included the participant’s age group, sex, race/ethnicity, alcohol, body mass index, diabetes, current tobacco use, Alcohol Use Disorders Identification Test-Concise (AUDIT-C) score, cirrhosis comorbidity index, hypertension, chronic obstructive pulmonary disease, Child-Pugh Score, location, baseline lab results (alanine aminotransferase, platelet count, creatinine, total bilirubin, international normalised ratio and Model For End-Stage Liver Disease-Sodium (MELD-Na)) and COVID-19 test month. The proportion of variants in the community was obtained from the weekly …

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  • Contributors BVJ and BD had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: JA. Acquisition, analysis, or interpretation of data: All authors. Drafting of the manuscript: BVJ, DRB and BD. Critical revision of the manuscript for important intellectual content: All authors. Statistical analysis: BVJ, DRB, YD and BD. Obtained funding: BVJ and BD. Administrative, technical or material support: All authors Supervision: BVJ and BD.

  • Funding Services supporting the analysis and interpretation of the data of this research project were generated by the VCU Massey Cancer Center Biostatistics Shared Resource, supported, in part, with funding from NIH-NCI Cancer Center Support Grant P30 CA016059.

  • Disclaimer The authors prepared this work in their personal capacity. The opinions expressed in this article are the author's own and do not reflect the view of the Department of Veterans Affairs or the United States government.

  • Competing interests BVJ received institutional research support from BMS, Exelixis, Exact Sciences, GSK, Glycotest, Inc, H3B biosciences, Viking therapeutics. DEK received institutional research support from Gilead Sciences, Glycotest, Astra Zeneca, Bayer and Exact Sciences. None of the other authors have personal or financial conflicts of interests to declare in relation to this publication

  • Provenance and peer review Not commissioned; externally peer reviewed.