{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:32:53Z","timestamp":1753893173473,"version":"3.41.2"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T00:00:00Z","timestamp":1736380800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Transplant."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>COVID-19 disease burden has been mitigated by vaccination; however, concerns persist regarding weakened immune responses in liver transplant (LT) recipients. This study investigates COVID-19 outcomes in LT recipients based on vaccination status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This single-center retrospective study identified LT recipients with PCR-confirmed COVID-19 infection from 03\/01\/2020 to 07\/31\/2023. Logistic regression analyses were conducted, adjusting for age, race, co-morbidities, number of immunosuppressive agents, and infection date.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 1,787 registered LT recipients, 361 had confirmed COVID-19 infection. Of those, 136 were unvaccinated and 225 were vaccinated. 13% had 1 vaccine dose, 31% had 2 vaccine doses, and 56% had 3 vaccine doses prior to infection. Logistic regression found higher mortality (<jats:italic>p<\/jats:italic>\u2009=\u20090.001) and hospitalization (<jats:italic>p<\/jats:italic>\u2009=\u20090.016) rates for older recipients, while those with 3 or more vaccine doses had lower mortality (<jats:italic>p<\/jats:italic>\u2009=\u20090.039) and hospitalization (<jats:italic>p<\/jats:italic>\u2009=\u20090.008) rates. Chronic kidney disease (CKD) increased risk of hospitalization (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001). Adjusting for the date when the Omicron variant became locally predominant, the protective effect from 3 or more vaccine doses declined to an OR (95% CI) of 0.58 (0.15\u20132.23), <jats:italic>p<\/jats:italic>\u2009=\u20090.39.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Three or more COVID-19 vaccine doses could decrease mortality for LT recipients, particularly older recipients and those with CKD. These individuals may benefit from vaccination and other interventions.<\/jats:p><\/jats:sec>","DOI":"10.3389\/frtra.2024.1515964","type":"journal-article","created":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T06:11:57Z","timestamp":1736403117000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical outcomes of COVID-19 infection in liver transplant recipients based on vaccination status"],"prefix":"10.3389","volume":"3","author":[{"given":"Vinathi","family":"Polamraju","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neeta","family":"Vachharajani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian F.","family":"Gage","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey S.","family":"Crippin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William C.","family":"Chapman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1111\/liv.15403","article-title":"Immunogenicity of COVID-19 vaccines in chronic liver disease and liver transplant recipients: a systematic review and meta-analysis","volume":"43","author":"Luo","year":"2023","journal-title":"Liver Int"},{"year":"","key":"B2","article-title":"Coronavirus Disease (COVID-19) Pandemic"},{"volume-title":"COVID Data Tracker","year":"2024","key":"B3"},{"key":"B4","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1097\/TP.0000000000003480","article-title":"Biomarkers of cytokine release syndrome predict disease severity and mortality from COVID-19 in kidney 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