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新冠后(post-COVID-19)条件下的偶发过敏疾病:来自韩国、日本和英国的多国队列研究。

Incident allergic diseases in post-COVID-19 condition: multinational cohort studies from South Korea, Japan and the UK.

机构信息

Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea.

Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea.

出版信息

Nat Commun. 2024 Apr 2;15(1):2830. doi: 10.1038/s41467-024-47176-w.


DOI:10.1038/s41467-024-47176-w
PMID:38565542
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10987608/
Abstract

As mounting evidence suggests a higher incidence of adverse consequences, such as disruption of the immune system, among patients with a history of COVID-19, we aimed to investigate post-COVID-19 conditions on a comprehensive set of allergic diseases including asthma, allergic rhinitis, atopic dermatitis, and food allergy. We used nationwide claims-based cohorts in South Korea (K-CoV-N; n = 836,164; main cohort) and Japan (JMDC; n = 2,541,021; replication cohort A) and the UK Biobank cohort (UKB; n = 325,843; replication cohort B) after 1:5 propensity score matching. Among the 836,164 individuals in the main cohort (mean age, 50.25 years [SD, 13.86]; 372,914 [44.6%] women), 147,824 were infected with SARS-CoV-2 during the follow-up period (2020-2021). The risk of developing allergic diseases, beyond the first 30 days of diagnosis of COVID-19, significantly increased (HR, 1.20; 95% CI, 1.13-1.27), notably in asthma (HR, 2.25; 95% CI, 1.80-2.83) and allergic rhinitis (HR, 1.23; 95% CI, 1.15-1.32). This risk gradually decreased over time, but it persisted throughout the follow-up period (≥6 months). In addition, the risk increased with increasing severity of COVID-19. Notably, COVID-19 vaccination of at least two doses had a protective effect against subsequent allergic diseases (HR, 0.81; 95% CI, 0.68-0.96). Similar findings were reported in the replication cohorts A and B. Although the potential for misclassification of pre-existing allergic conditions as incident diseases remains a limitation, ethnic diversity for evidence of incident allergic diseases in post-COVID-19 condition has been validated by utilizing multinational and independent population-based cohorts.

摘要

越来越多的证据表明,COVID-19 病史的患者发生不良后果的几率更高,如免疫系统紊乱等。因此,我们旨在全面调查 COVID-19 后包括哮喘、过敏性鼻炎、特应性皮炎和食物过敏在内的一系列过敏性疾病。我们使用了韩国(K-CoV-N;n=836164;主要队列)、日本(JMDC;n=2541021;复制队列 A)和英国生物样本库(UKB;n=325843;复制队列 B)基于全国性索赔的队列,在 COVID-19 后 1:5 进行倾向评分匹配。在主要队列的 836164 名个体中(平均年龄,50.25 岁[SD,13.86];372914[44.6%]为女性),147824 名个体在随访期间(2020-2021 年)感染了 SARS-CoV-2。在 COVID-19 确诊后的前 30 天之后,患过敏性疾病的风险显著增加(HR,1.20;95%CI,1.13-1.27),尤其是哮喘(HR,2.25;95%CI,1.80-2.83)和过敏性鼻炎(HR,1.23;95%CI,1.15-1.32)。这种风险随着时间的推移逐渐降低,但在整个随访期间(≥6 个月)持续存在。此外,风险随 COVID-19 严重程度的增加而增加。值得注意的是,至少接种两剂 COVID-19 疫苗对随后发生的过敏性疾病具有保护作用(HR,0.81;95%CI,0.68-0.96)。在复制队列 A 和 B 中也报告了类似的发现。尽管将先前存在的过敏性疾病误诊为新发病例的可能性仍然是一个限制因素,但利用多国和独立的基于人群的队列验证了 COVID-19 后状态下发生过敏性疾病的证据具有种族多样性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e431/10987608/848d0e83c663/41467_2024_47176_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e431/10987608/848d0e83c663/41467_2024_47176_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e431/10987608/848d0e83c663/41467_2024_47176_Fig1_HTML.jpg

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[5]
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[6]
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[8]
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[9]
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[10]
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本文引用的文献

[1]
Long-Term Autoimmune Inflammatory Rheumatic Outcomes of COVID-19 : A Binational Cohort Study.

Ann Intern Med. 2024-3

[2]
Hand and Oral Hygiene Practices of South Korean Adolescents Before and During the COVID-19 Pandemic.

JAMA Netw Open. 2023-12-1

[3]
Global burden of vaccine-associated anaphylaxis and their related vaccines, 1967-2023: A comprehensive analysis of the international pharmacovigilance database.

Allergy. 2024-3

[4]
Autoimmune and Autoinflammatory Connective Tissue Disorders Following COVID-19.

JAMA Netw Open. 2023-10-2

[5]
Large cohort study shows increased risk of developing atopic dermatitis after COVID-19 disease.

Allergy. 2024-1

[6]
The immunology of long COVID.

Nat Rev Immunol. 2023-10

[7]
Global, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019: A systematic analysis for the Global Burden of Disease Study 2019.

Allergy. 2023-8

[8]
Covid-19: US studies show racial and ethnic disparities in long covid.

BMJ. 2023-3-6

[9]
Long-Term Consequences of Asymptomatic SARS-CoV-2 Infection: A Systematic Review and Meta-Analysis.

Int J Environ Res Public Health. 2023-1-16

[10]
Long COVID: major findings, mechanisms and recommendations.

Nat Rev Microbiol. 2023-3

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