Department of Translational Medicine, University of Ferrara, Ferrara, Italy.
Department of Ophthalmology, Ospedali Privati Forlì "Villa Igea," Forlì, Italy.
Cornea. 2022 Dec 1;41(12):1536-1538. doi: 10.1097/ICO.0000000000003101. Epub 2022 Aug 10.
The aim of the study was to present the rates of rejection from 2018 to 2021 and evaluate the purported association between COVID-19 vaccination and corneal graft rejection.
Cases of corneal graft rejection diagnosed between January 2018 and December 2021 were reviewed. The conditional Poisson regression model of the self-controlled case series method was used to estimate the incidence risk ratio of graft rejection after COVID-19 vaccination risk period compared with the control period. Based on outcomes of eyes that underwent keratoplasty from January 2018 to December 2020, Cox proportional hazard models were fitted with previous COVID-19 vaccination as a time-varying covariate.
Over the past 4 years, the annual tally of diagnosed cases of graft rejection (19 cases in year 2018, 19 cases in year 2019, 21 cases in year 2020, and 18 cases in year 2021) has remained relatively stable. Using the conditional Poisson regression analysis, no significant increase in the incidence rate of rejection in the risk period after COVID-19 vaccination was found (incidence risk ratio = 0.56, 95% confidence interval [CI] = 0.13-2.28, P = 0.70). Fitted as a time-varying covariate, previous COVID-19 vaccination was not associated with graft rejection in both unadjusted (hazard ratio =0.77, 95% CI = 0.29-5.46, P = 0.77) and adjusted Cox models (hazard ratio = 0.75, 95% CI = 0.10-5.52, P = 0.78).
No notable increase in rates of corneal graft rejection was noted in year 2021 when COVID-19 vaccination was broadly implemented. The apparent temporal relationship between COVID vaccination and corneal graft rejection may not represent a causative association.
本研究旨在报告 2018 年至 2021 年的排斥率，并评估 COVID-19 疫苗接种与角膜移植排斥之间的所谓关联。
回顾了 2018 年 1 月至 2021 年 12 月期间诊断为角膜移植排斥的病例。采用自身对照病例系列的条件泊松回归模型，估计 COVID-19 疫苗接种风险期与对照期后移植排斥的发病率风险比。根据 2018 年 1 月至 2020 年 12 月接受角膜移植的眼睛的结果，将之前的 COVID-19 疫苗接种作为时变协变量拟合 Cox 比例风险模型。
在过去的 4 年中，每年诊断出的移植排斥病例数（2018 年 19 例、2019 年 19 例、2020 年 21 例和 2021 年 18 例）相对稳定。使用条件泊松回归分析，在 COVID-19 疫苗接种后的风险期内，排斥发生率没有显著增加（发病率风险比=0.56，95%置信区间[CI]为 0.13-2.28，P=0.70）。作为时变协变量拟合时，未调整的 Cox 模型（风险比=0.77，95%CI=0.29-5.46，P=0.77）和调整后的 Cox 模型（风险比=0.75，95%CI=0.10-5.52，P=0.78）均未发现先前 COVID-19 疫苗接种与移植排斥之间存在关联。
当 COVID-19 疫苗广泛接种时，2021 年角膜移植排斥率没有明显增加。COVID 疫苗接种与角膜移植排斥之间的明显时间关系可能不代表因果关系。
