Lee Tae Eun, Ahn Sung Hyun, Jeong Cho Yun, Kim Jong Seung, You In Cheon
Department of Ophthalmology, Jeonbuk National University Medical School, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea.
Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju, Republic of Korea ; and.
Cornea. 2025 Feb 1;44(2):168-179. doi: 10.1097/ICO.0000000000003556. Epub 2024 May 8.
The purpose of this study was to determine the risk of herpesviral keratitis associated with 4 coronavirus disease 2019 (COVID-19) vaccines approved in South Korea, using large-scale data from the National Health Insurance Service.
The study included 8,528,254 individuals, with cohorts categorized based on COVID-19 vaccination status. Two investigations were conducted: The first aimed to assess the risk of new-onset herpesviral keratitis while the second study focused on the risk of relapse in individuals with a preexisting diagnosis. Propensity score matching was used for cohort balancing, and various covariates, including vaccine types and comorbidities, were considered. Statistical analyses, including Cox proportional hazard regression, were used to calculate adjusted hazard ratio (aHR) and assess the risk of herpesviral keratitis.
Individuals receiving COVID-19 vaccination exhibited a higher risk of new-onset herpesviral keratitis compared with the unvaccinated control group (aHR 1.43, 95% confidence interval, 1.19-1.73). Both mRNA and non-mRNA vaccines demonstrated an increased risk. Individuals with preexisting herpetic keratitis who received COVID-19 vaccination showed a higher risk of relapse herpesviral keratitis compared with the unvaccinated control group (aHR 1.98, 95% CI, 1.29-3.03). Sensitivity analyses supported the robustness of the results.
This analysis of a large national health insurance database suggests an increased risk of both new-onset and relapse of herpesviral keratitis associated with COVID-19 vaccination in South Korea. While COVID-19 vaccination is crucial for pandemic control, health care providers should be aware of potential herpesvirus reactivation and consider appropriate prophylaxis and treatment for at-risk individuals.
本研究旨在利用韩国国民健康保险服务的大规模数据，确定韩国批准的4种2019冠状病毒病（COVID-19）疫苗与疱疹病毒性角膜炎的相关性风险。
该研究纳入了8,528,254名个体，根据COVID-19疫苗接种状况对队列进行分类。进行了两项调查：第一项旨在评估新发疱疹病毒性角膜炎的风险，而第二项研究聚焦于既往有诊断的个体的复发风险。倾向评分匹配用于队列平衡，并考虑了包括疫苗类型和合并症在内的各种协变量。使用包括Cox比例风险回归在内的统计分析来计算调整后的风险比（aHR）并评估疱疹病毒性角膜炎的风险。
与未接种疫苗的对照组相比，接种COVID-19疫苗的个体发生新发疱疹病毒性角膜炎的风险更高（aHR 1.43，95%置信区间，1.19 - 1.73）。mRNA疫苗和非mRNA疫苗均显示风险增加。与未接种疫苗的对照组相比，既往有疱疹性角膜炎且接种COVID-19疫苗的个体复发疱疹病毒性角膜炎的风险更高（aHR 1.98，95% CI，1.29 - 3.03）。敏感性分析支持了结果的稳健性。
这项对大型国家健康保险数据库的分析表明，在韩国，与COVID-19疫苗接种相关的疱疹病毒性角膜炎的新发和复发风险均有所增加。虽然COVID-19疫苗接种对于疫情控制至关重要，但医疗保健提供者应意识到潜在的疱疹病毒再激活，并考虑对高危个体进行适当的预防和治疗。
