COVID-19 发病率和严重程度与年龄相关性黄斑变性患者：韩国全国队列研究。

COVID-19 Morbidity and Severity in Patients With Age-Related Macular Degeneration: A Korean Nationwide Cohort Study.

机构信息

From Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine (J.M.Y, J.Y.L); Department of Ophthalmology, Dongguk University Ilsan Hospital, Goyang, Republic of Korea; Department of Data Science, Sejong University College of Software Convergence, Seoul, Republic of Korea (S.Y.M, D.K.Y, S.W.L).

Department of Data Science, Sejong University College of Software Convergence, Seoul, Republic of Korea (S.Y.M, D.K.Y, S.W.L).

出版信息

Am J Ophthalmol. 2022 Jul;239:159-169. doi: 10.1016/j.ajo.2021.05.024. Epub 2021 Jun 6.

DOI:10.1016/j.ajo.2021.05.024

PMID:34102151

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8179838/

Abstract

PURPOSE

To determine the potential association between age-related macular degeneration (AMD), a representative chronic age-related degenerative disease of the retina associated with inflammation and aging, and susceptibility to SARS-CoV-2 infection and severe COVID-19 outcomes.

DESIGN

Nationwide cohort study with propensity-score matching.

METHODS

A population-based nationwide cohort in Korea was examined. Data were obtained from the Health Insurance Review & Assessment Service of Korea, including all patients aged ≥40 years who underwent SARS-CoV-2 testing in South Korea between January 1, 2020 and May 15, 2020 (excluding self-referral). The primary outcome was SARS-CoV-2 test positivity and the secondary outcome was severe clinical outcome of COVID-19.

RESULTS

The unmatched cohort consisted of 135,435 patients who were tested for SARS-CoV-2: 4531 patients (3.3%) tested positive for SARS-CoV-2 and 5493 (4.1%) had AMD. After propensity score matching, exudative AMD was associated with an increased likelihood of susceptibility to SARS-CoV-2 infection (adjusted odds ratio [aOR], 1.50; 95% confidence interval [CI], 1.03-2.25), and a considerably greater risk of severe clinical outcomes of COVID-19 (aOR, 2.26; 95% CI, 1.02-5.26), but not any AMD and non-exudative AMD.

CONCLUSIONS

In a Korean nationwide cohort, data suggest that clinicians should be aware of the greater risk of susceptibility to severe clinical outcomes of COVID-19 in patients with exudative AMD. These findings provide an improved understanding of the relationship between the pathogenesis of COVID-19 and chronic neurological disorders.

摘要

目的

确定年龄相关性黄斑变性（AMD）与 SARS-CoV-2 感染和严重 COVID-19 结局之间的潜在关联。AMD 是一种与炎症和衰老相关的视网膜退行性疾病，是一种代表性的慢性年龄相关性疾病。

设计

全国性队列研究与倾向评分匹配。

方法

在韩国进行了一项基于人群的全国性队列研究。数据来自韩国健康保险审查与评估服务，包括 2020 年 1 月 1 日至 2020 年 5 月 15 日期间在韩国接受 SARS-CoV-2 检测的所有≥40 岁患者（不包括自我转诊）。主要结局是 SARS-CoV-2 检测阳性，次要结局是 COVID-19 的严重临床结局。

结果

未匹配的队列包括 135435 名接受 SARS-CoV-2 检测的患者：4531 名（3.3%）患者 SARS-CoV-2 检测阳性，5493 名（4.1%）患有 AMD。在倾向评分匹配后，渗出性 AMD 与 SARS-CoV-2 感染易感性增加相关（调整后的优势比[aOR]，1.50；95%置信区间[CI]，1.03-2.25），以及 COVID-19 严重临床结局的风险显著增加（aOR，2.26；95%CI，1.02-5.26），而非任何 AMD 和非渗出性 AMD。