COVID-19 infection is associated with an elevated risk for autoimmune blistering diseases while COVID-19 vaccination decreases the risk: A large-scale population-based cohort study of 112 million individuals - 19/02/25
, Khalaf Kridin, MD, PhD d, e, f, Henner Zirpel, MD, PhD g, Gema Hernandez, PhD h, i, Mehmet Akyuz, PhD j, Diamant Thaci, MD, PhD g, Enno Schmidt, MD, PhD d, k, Ralf J. Ludwig, MD, PhD d, g, k
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Abstract |
Background |
Numerous diseases associated with COVID-19 infection and vaccination have been reported, including conditions such as the autoimmune blistering diseases (AIBDs) pemphigus and pemphigoid. However, robust evidence supporting these associations is lacking.
Objective |
To investigate the risk of developing AIBD following COVID-19 infection and vaccination.
Methods |
Population-based retrospective cohort study utilizing data from over 112 million patients. The risk of AIBD within 3 months was compared among 3 cohorts: COVID-19 infection, COVID-19 vaccination, and controls, along with 7 sensitivity analyses.
Results |
COVID-19 infection was associated with an increased risk of AIBD (hazard ratio [HR] 1.508, 95% CI 1.260-1.805), with the risk being more pronounced for pemphigus (HR 2.432, 1.618-3.657) compared to bullous pemphigoid (HR 1.376, 1.019-1.857). Conversely, COVID-19 vaccination was associated with an almost halved risk of AIBD (HR 0.514, 0.394-0.672), with the risk reduction most significant for pemphigus (HR 0.477, 0.241-0.946). Comparisons between COVID-19 infection and vaccination revealed a more than threefold increased risk of AIBD in the infection cohort (HR 3.130, 2.411-4.063), particularly for pemphigus (HR 5.508, 2.973-10.205).
Limitations |
Retrospective design and potential under-reporting of COVID-19 cases and vaccinations.
Conclusion |
COVID-19 infection significantly increases the risk of AIBD while vaccination appears to reduce this risk.
Le texte complet de cet article est disponible en PDF.Key words : autoimmune blistering diseases, autoimmune disease, autoimmunity, COVID-19 infection, COVID-19 vaccination, pemphigoid, pemphigus, population-based cohort study
Abbreviations used : AIBD, BP, CI, EHR, HR, PSM
Plan
| Funding sources: This research was funded by the Cluster of Excellence “Precision Medicine in Chronic Inflammation” (EXC 2167), DFG Individual Grant LU 877/25-1, all from the Deutsche Forschungsgemeinschaft and the Schleswig-Holstein Excellence-Chair Program from the State of Schleswig Holstein. |
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| Patient consent: Not applicable. |
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| IRB approval status: Not required. |
Vol 92 - N° 3
P. 452-463 - mars 2025 Retour au numéro
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