The following is a summary of “COVID-19 infection is associated with an elevated risk for autoimmune blistering diseases while COVID-19 vaccination decreases the risk: A large-scale population-based cohort study of 112 million individuals,” published in the November 2024 issue of Dermatology by Curman et al. 

Numerous diseases, including autoimmune blistering diseases (AIBD) like pemphigus and pemphigoid, were reported to be associated with COVID-19 infection and vaccination, though concrete evidence remained elusive.  

Researchers conducted a retrospective study to examine the risk of developing AIBD after COVID-19 infection and vaccination.  

They used data from over 112 million patients and compared the risk of AIBD for 3 months among 3 groups: those with COVID-19 infection, those with COVID-19 vaccination, and controls, alongside 7 separate sensitivity analyses were also done.   

The results showed that COVID-19 infection was associated with a 1.508-fold increased risk of AIBD (95% CI: 1.260-1.805), with a more pronounced risk for pemphigus (HR: 2.432, 95% CI: 1.618-3.657) compared to bullous pemphigoid (HR: 1.376, 95% CI: 1.019-1.857). In contrast, COVID-19 vaccination was associated with a nearly halved risk of AIBD (HR: 0.514, 95% CI: 0.394-0.672), especially for pemphigus (HR: 0.477, 95% CI: 0.241-0.946). Comparing COVID-19 infection and vaccination revealed a more than threefold increased risk of AIBD in the infection cohort (HR: 3.130, 95% CI: 2.411-4.063), particularly for pemphigus (HR: 5.508, 95% CI: 2.973-10.205).  

Investigators concluded that COVID-19 infection significantly increased the risk of AIBD, while vaccination appeared to reduce the risk.   

Source: jaad.org/article/S0190-9622(24)03111-6/fulltext