Curman Philip, Kridin Khalaf, Zirpel Henner, Hernandez Gema, Akyuz Mehmet, Thaci Diamant, Schmidt Enno, Ludwig Ralf J
Dermato-Venereology Clinic, Karolinska University Hospital, Stockholm, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Dermatology and Venereology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden; Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.
Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany; Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel; Unit of Dermatology and Skin Research Laboratory, Galilee Medical Center, Nahariya, Israel.
J Am Acad Dermatol. 2025 Mar;92(3):452-463. doi: 10.1016/j.jaad.2024.10.063. Epub 2024 Nov 7.
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.
To investigate the risk of developing AIBD following COVID-19 infection and vaccination.
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.
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).
Retrospective design and potential under-reporting of COVID-19 cases and vaccinations.
COVID-19 infection significantly increases the risk of AIBD while vaccination appears to reduce this risk.
已有许多与新冠病毒感染及疫苗接种相关的疾病被报道，包括自身免疫性疱病（AIBD）等疾病，如天疱疮和类天疱疮。然而，支持这些关联的有力证据尚缺。
调查新冠病毒感染及疫苗接种后发生AIBD的风险。
基于人群的回顾性队列研究，利用来自超过1.12亿患者的数据。比较了三个队列在3个月内发生AIBD的风险：新冠病毒感染队列、新冠病毒疫苗接种队列和对照组，同时进行了7项敏感性分析。
新冠病毒感染与AIBD风险增加相关（风险比[HR]1.508，95%置信区间1.260-1.805），与大疱性类天疱疮（HR 1.376，1.019-1.857）相比，天疱疮的风险更显著（HR 2.432，1.618-3.657）。相反，新冠病毒疫苗接种与AIBD风险降低近一半相关（HR 0.514，0.394-0.672），天疱疮的风险降低最为显著（HR 0.477，0.241-0.946）。新冠病毒感染队列与疫苗接种队列之间的比较显示，感染队列中AIBD风险增加了三倍多（HR 3.130，2.411-4.063），尤其是天疱疮（HR 5.508，2.973-10.205）。
回顾性设计以及新冠病毒病例和疫苗接种可能存在报告不足的情况。
新冠病毒感染显著增加AIBD风险，而疫苗接种似乎可降低这一风险。
