Adverse reactions to inactivated COVID-19 vaccination in patients with chronic liver disease: The effect of anxiety

Figures & data

Table 1. Baseline characteristics of patients with chronic liver disease and cardinal analysis of factors associated with adverse effects, N = 160.

Variables	Category	N	(%)
Total		160	100.0%
Sex	Male	102	63.8%
	Female	58	36.3%
Age (years)	≤60	139	86.9%
	>60	21	13.1%
Residence	Rural	106	66.3%
	City	54	33.8%
Occupation	Farmer	58	36.3%
	Non-Farmer	102	63.8%
Education level	Junior Secondary and below	78	48.8%
	Senior Secondary	30	18.8%
	Junior College and above	52	32.5%
Anxiety	Yes	85	53.1%
	No	75	46.9%
Hepatitis B	Yes	102	63.8%
	No	58	36.3%
Nonalcoholic fatty liver disease	Yes	57	35.6%
	No	103	64.4%
Other Liver Diseases	Yes	34	21.3%
	No	126	78.8%
Liver cirrhosis	No	142	88.8%
	Yes	18	11.3%
Comorbidity	No comorbidity	96	60.0%
	One comorbidity	40	25.0%
	More than one comorbidity	24	15.0%
Hypertension	Yes	30	18.8%
	No	130	81.3%
Hyperlipidemia	Yes	25	15.6%
	No	135	84.4%
Diabetes	Yes	16	10.0%
	No	144	90.0%
Hyperuricemia	Yes	9	5.6%
	No	151	94.4%
Respiratory diseases	Yes	5	8.0%
	No	152	95.0%
Kidney disease	Yes	2	1.3%
	No	158	98.8%
Treatment	Yes	82	51.3%
	No	78	48.8%
Allergic reaction	No	146	91.3%
	Yes	14	8.8%

Table 2. Univariate analysis of factors associated with adverse reactions of COVID-19 vaccine. N = 160.

Variables	Category	No adverse reactions		Incidence of adverse reactions		χ2	P
		n	(%)	n	(%)
Total		89	55.6%	71	44.4%
Sex	Male	58	56.9%	44	43.1%	0.175	0.676
	Female	31	53.4%	27	46.6%
Age (years)	≤60	76	54.7%	63	45.3%	0.386	0.534
	>60	13	61.9%	8	38.1%
Residence	Rural	61	57.5%	45	42.5%	0.47	0.493
	City	28	51.9%	26	48.1%
Occupation	Farmer	38	65.5%	20	34.5%	3.607	0.058
	Non-Farmer	51	50.0%	51	50.0%
Education level	Junior Secondary and below	49	62.8%	29	37.2%	3.59	0.166
	Senior Secondary	16	53.3%	14	46.7%
	Junior College and above	24	46.2%	28	53.8%
Anxiety	Yes	41	48.2%	44	51.8%	4.012	0.045
	No	48	64.0%	27	36.0%
Hepatitis B	Yes	55	53.9%	47	46.1%	0.331	0.565
	No	34	58.6%	24	41.4%
Nonalcoholic fatty liver disease	Yes	36	63.2%	21	36.8%	2.036	0.154
	No	53	51.5%	50	48.5%
Other Liver Diseases	Yes	17	50.0%	17	50.0%	0.553	0.126
	No	72	57.1%	54	42.9%
Liver cirrhosis	No	81	57.0%	61	43.0%	1.027	0.311
	Yes	8	44.4%	10	55.6%
Comorbidity	No comorbidity	50	52.1%	46	47.9%	4.769	0.092
	One comorbidity	28	70.0%	12	30.0%
	More than one comorbidity	11	45.8%	13	54.2%
Treatment	Yes	50	61.0%	32	39.0%	1.951	0.162
	No	39	50.0%	39	50.0%
Allergic reaction	No	82	56.2%	64	43.8%	0.197	0.657
	Yes	7	50.0%	7	50.0%

Table 3. Relationship between adverse reactions to inactivated COVID-19 vaccine and anxiety in different populations, N = 160.

Population stratification		Anxious		Not anxious
		Incidence of adverse reactions				χ2	P
		n	(%)	n	(%)
Sex	Male	28	52.8%	16	32.7%	4.226	0.040
	Female	16	50.0%	11	42.3%	0.341	0.559
Age (years)	≤60	71	51.1%	68	48.9%	1.780	0.182
	>60	14	66.7%	7	33.3%	3.387	0.076
Residence	Rural	30	48.4%	15	34.1%	2.153	0.142
	City	14	60.9%	12	38.7%	2.597	0.107
Education level	Junior Secondary and below	20	42.6%	9	29.0%	1.462	0.227
	Senior Secondary and above	24	63.2%	18	40.9%	4.040	0.044
Hepatitis B	Yes	29	56.9%	18	35.3%	4.774	0.029
Nonalcoholic fatty liver disease	Yes	12	38.7%	9	34.6%	0.102	0.750
Other Liver Diseases	Yes	12	63.2%	5	33.3%	2.982	0.084
Liver cirrhosis	No	37	50.0%	24	35.3%	3.127	0.077
	Yes	7	63.6%	3	42.9%	0.748	0.387
Comorbidity	No	18	45.0%	7	29.2%	1.580	0.209
	Yes	26	57.8%	20	39.2%	3.301	0.069
Treatment	Yes	23	56.1%	9	22.0%	10.045	0.002
	No	21	47.7%	18	52.9%	0.209	0.648
Allergic reaction	Yes	5	62.5%	2	33.3%	1.167	0.280
	No	39	50.6%	25	36.2%	3.072	0.080

Table 4. Multiple logistic regression analysis of factors associated with anxiety. N = 160.

Variables	Categories	P	OR (95%CI)
Sex	Male vs. Female	0.735	0.579–2.171
Education level	Senior Secondary and above vs. Junior Secondary and below	0.056	0.985–3.554
Hepatitis B	Yes vs. No	0.666	0.445–3.554
Treatment	Yes vs. No	0.805	0.418–3.080
Allergic reaction	Yes vs. No	0.999	0

Table 5. The relationship between adverse reactions to inactivated COVID-19 vaccine and anxiety in different populations.

Author	Study design	Study period	Study sample	Setting	Vaccine	Content	Reference
Anne M.et al.	Cross-sectional study	2021		America	COVID-19	Sixty-four cases of anxiety-related adverse reactions were reported, with dizziness or headache in 36 cases (56%), pallor and excessive sweating in 20 cases (31%), nausea and vomiting in 16 cases (25%), and hypotension in 10 cases (16%)	15
Vincenza et al.	Cross-sectional study	2021	Total: 314664	Italy	COVID-19	Anxiety accounted for 24% of the 1704 adverse reactions (n = 339).	16
Tiffany A. et al.	Review	2017	Total:120	America	HPV. et al	Seven articles reported anxiety-related adverse reactions. The most frequently reported adverse reactions were syncope, dizziness, fatigue, headache, and tic disorder or involuntary movements.	13
Awnish K. et al.	Review	2017	Total:1037	India	JE, DTP et al	Anxiety-related adverse reactions were reported in 175 (17%) articles. Of these, 95 (54%) articles reported anxiety-related reactions to the Japanese encephalitis (JE) vaccine and 56 (32%) articles reported anxiety-related reactions to the measles vaccine.	17