Letter to the Editor
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2021; 9(26): 7959-7962
Published online Sep 16, 2021. doi: 10.12998/wjcc.v9.i26.7959
Should people with chronic liver diseases be vaccinated against COVID-19?
Li-Ping Chen, Qing-Hong Zeng, Yuan-Feng Gong, Fa-Liang Liang
Li-Ping Chen, Qing-Hong Zeng, Yuan-Feng Gong, Fa-Liang Liang, Department of General Surgery, Xinxing People’s Hospital, Yunfu 527400, Guangdong Province, China
Yuan-Feng Gong, Department of Hepatobiliary Surgery, The Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou 510095, Guangdong Province, China
Author contributions: Chen LP and Liang FL designed and performed research; Zeng QH and Gong YF wrote the letter; Chen LP revised the letter.
Conflict-of-interest statement: No potential conflicts of interest and financial support for this work.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fa-Liang Liang, MD, Chief Doctor, Surgeon, Department of General Surgery, Xinxing People’s Hospital, No. 2 Chengnanwai New Avenue, Yunfu 527400, Guangdong Province, China. 5598071@qq.com
Received: May 30, 2021
Peer-review started: May 30, 2021
First decision: June 27, 2021
Revised: June 28, 2021
Accepted: August 16, 2021
Article in press: August 16, 2021
Published online: September 16, 2021
Processing time: 102 Days and 19.3 Hours
Abstract

Hepatic impairment in coronavirus disease 2019 (COVID-19) may derive from cholangiocyte damage in the beginning, but not from direct infection of hepatocytes. Chronic liver disease patients co-infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exhibited overexpression of angiotensin-converting enzyme 2 receptors and overwhelming cytokine storm. Consensus has been reached that we should encourage as many people as possible to be vaccinated in order to achieve herd immunity. SARS-CoV-2 vaccines can prevent or alleviate severe infection and cytokine storm. It is recommended that all adult patients with chronic liver diseases and liver transplant recipients should receive COVID-19 vaccines using the standard dose and schedule. Data is not yet sufficient to compare the efficacy of different types of vaccines used in chronic liver disease patients.

Keywords: Chronic liver disease; Vaccine; COVID-19; SARS-CoV-2; Hepatic impairment

Core Tip: Chronic liver disease patients co-infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exhibited overexpression of angiotensin-converting enzyme 2 receptors and overwhelming cytokine storm. SARS-CoV-2 vaccines can prevent or alleviate severe infection, and cytokine storm. Recently, a question has been raised whether chronic liver disease patients should be vaccinated against coronavirus disease 2019 (COVID-19). The American Association for the Study of Liver Diseases and European Association for the Study of the Liver Expert Panel suggested that all adult patients with chronic liver disease and liver transplant recipients can receive the COVID-19 vaccines using the standard dose and schedule.