Letter to the editor: Could COVID-19 vaccination reduce postinfection mortality in most patients with cirrhosis?

To the editor,

I read with interest regarding the use of COVID‐19 vaccination in patients with cirrhosis. It is well recognized that patients with cirrhosis, especially decompensated individuals, are prone to acquire bacterial infections as well as viral infections. COVID‐19 vaccination is definitely needed for patients with cirrhosis to prevent infection during the pandemic era of COVID‐19 worldwide. Dr. John et al. proved that COVID‐19 vaccination in patients with cirrhosis was safe and associated with reduced COVID‐19 infection as well as the mortality.[ , ] Though inspiring, some points need further clarification.

Among the studied patients, Child‐Pugh class A accounted for about 77%, and class B accounted for about 21%, whereas <2% of patients belonged to Child‐Pugh class C. This study enrolled very few patients with decompensated cirrhosis. As shown in the patients’ characteristics, decompensated parameters such as presence of severe ascites, jaundice, or history of variceal bleeding were rarely found. Also, the safety in patients with low platelet counts and/or poor clotting profiles was not revealed. All these patients similarly require the protection of vaccine against infection with COVID‐19 urgently. The safety of the COVID‐19 vaccine in patients with decompensated cirrhosis may elicit great concern in both patients as well as clinicians. The current study demonstrated only the safety and efficacy of COVID‐19 vaccine in patients with compensated cirrhosis. However, further studies on the safety and efficacy of various COVID‐19 vaccines in patients with decompensated cirrhosis are still awaited.

CONFLICT OF INTEREST

Nothing to report.