韩国急性横贯性脊髓炎与新冠病毒疫苗接种之间的关联：自我对照病例系列研究。
The association between acute transverse myelitis and COVID-19 vaccination in Korea: Self-controlled case series study.
作者信息
Lim Eunsun, Kim Yoo Hwan, Jeong Na-Young, Kim Su-Hyun, Won Heehyun, Bae Jong-Seok, Choi Nam-Kyong
机构信息
Department of Health Convergence, College of Science and Industry Convergence, Ewha Womans University, Seoul, Republic of Korea.
Department of Neurology, Hallym University Sacred Heart Hospital, College of Medicine, Hallym Universit, Anyang, Republic of Korea.
出版信息
Eur J Neurol. 2025 Jan;32(1):e70020. doi: 10.1111/ene.70020.
BACKGROUND
Acute transverse myelitis (ATM) has been reported as a potential association between COVID-19 vaccination. In this study, we aimed to investigate the association between the COVID-19 vaccination and ATM.
METHODS
A self-controlled case series study was performed using a large database that combine the COVID-19 vaccine registry and the national claims database. The COVID-19 vaccination data included information on individuals aged 18 and above who received COVID-19 vaccination from February 26, 2021, to August 31, 2022. The claims database covered the entire Korean population for the period between January 1, 2002 to August 31, 2022. Patients who develop ATM within 1-42 days following COVID-19 vaccination were included. The observation period was 270 days after the first dose of the COVID-19 vaccine. The incidence rate ratio (IRR) and 95% confidence interval (CI) were estimated using a conditional Poisson regression model.
RESULTS
A total of 159 ATM patients were included. Among them, 82 (51.6%) were male, and mean age was 55.4 (±17.4) years. The IRR was 2.41 (95% CI: 1.76-3.30) for the ATM risk within 1-42 days after COVID-19 vaccination. The IRR by vaccine product was 3.31 (95% CI: 1.81-6.05) for ChAdOx1-S; 1.99 (95% CI: 1.30-3.03) for BNT162b2; 2.57 (95% CI: 1.14-5.97) for mRNA-1273; and 3.33 (95% CI: 0.30-36.44) for Ad26.COV2.S.
CONCLUSION
These findings indicated an increased risk of ATM following COVID-19 vaccination within 42 days. An association with the risk of ATM was found both for viral vector and mRNA vaccines.
背景
急性横贯性脊髓炎（ATM）已被报告为与新冠病毒疫苗接种之间可能存在的关联。在本研究中，我们旨在调查新冠病毒疫苗接种与ATM之间的关联。
方法
使用一个将新冠病毒疫苗接种登记册和国家理赔数据库相结合的大型数据库进行了一项自身对照病例系列研究。新冠病毒疫苗接种数据包括2021年2月26日至2022年8月31日期间接种新冠病毒疫苗的18岁及以上个体的信息。理赔数据库涵盖了2002年1月1日至2022年8月31日期间的全体韩国人口。纳入在新冠病毒疫苗接种后1至42天内发生ATM的患者。观察期为首次接种新冠病毒疫苗后的270天。使用条件泊松回归模型估计发病率比（IRR）和95%置信区间（CI）。
结果
共纳入159例ATM患者。其中，82例（51.6%）为男性，平均年龄为55.4（±17.4）岁。新冠病毒疫苗接种后1至42天内ATM风险的IRR为2.41（95%CI：1.76 - 3.30）。按疫苗产品划分的IRR，ChAdOx1-S为3.31（95%CI：1.81 - 6.05）；BNT162b2为1.99（95%CI：1.30 - 3.03）；mRNA-1273为2.57（95%CI：1.14 - 5.97）；Ad26.COV2.S为3.33（95%CI：0.30 - 36.44）。
结论
这些发现表明新冠病毒疫苗接种后42天内ATM风险增加。病毒载体疫苗和mRNA疫苗均与ATM风险存在关联。
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