Internal Medicine
Partner With Us
Advertisement
From the Journals

COVID-19 Increases Autoimmune Blistering Disease Risk, Study Finds

COVID-19 infection significantly increases autoimmune blistering disease risk, while vaccination appears protective, researchers report in a study analyzing 112 million patient records

Conexiant

A large-scale study of over 112 million patients found that COVID-19 infections may increase the risk of autoimmune blistering diseases, while COVID-19 vaccination could be associated with a reduced risk.

In the population-based retrospective cohort study, published in the Journal of the American Academy of Dermatology, investigators reported that COVID-19 infections were linked to a 50.8% increased risk of autoimmune blistering diseases (AIBD). The risk was particularly pronounced for pemphigus compared with bullous pemphigoid. Conversely, COVID-19 vaccination was associated with a nearly halved risk of AIBD, with the most significant reduction observed for pemphigus. When comparing patients with prior COVID-19 infections with those who were vaccinated, the infected cohort had over a threefold increased risk of AIBD.

The investigators utilized TriNetX, a global federated research network with access to over 112 million electronic health records. Patients were categorized into three cohorts:

  • COVID-19 infections (no vaccination within the prior 6 months)
  • COVID-19 vaccination (no prior infection within 6 months)
  • Control group (no history of COVID-19 infections or vaccination).

The investigators assessed the incidence of pemphigus and pemphigoid within 3 months of the index event and used propensity-score matching (PSM) to minimize confounding variables. Seven sensitivity analyses were performed, incorporating extended study periods, alternative follow-up criteria, and additional covariate adjustments, all of which confirmed the robustness of the findings.

"COVID-19 vaccination is associated with a significantly reduced, even halved, risk of AIBD within 3 months, highlighting the protective effects of vaccination," said lead study author Philip Curman MD, PhD, of the Dermato-Venereology Clinic at the Karolinska University Hospital in Stockholm, and colleagues.

Despite multiple sensitivity analyses, the study's retrospective design posed inherent limitations, including potential underreporting of COVID-19 cases or vaccinations and possible misclassification of AIBD diagnoses.

The findings highlighted the need for post–COVID-19 infection monitoring for autoimmune diseases and reinforcement of the broader benefits of vaccination beyond infection prevention. Clinicians should be aware of the increased AIBD risk in patients who experienced COVID-19 infections and consider early diagnosis and intervention strategies.

Full authors' disclosures are available in the study.