Incident allergic diseases in post-COVID-19 condition: multinational cohort studies from South Korea, Japan and the UK

Jiyeon Oh, Myeongcheol Lee, Minji Kim, Hyeon Jin Kim, Seung Won Lee, Sang Youl Rhee, Ai Koyanagi, Lee Smith, Min Seo Kim, Hayeon Lee (), Jinseok Lee () and Dong Keon Yon ()
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Jiyeon Oh: Kyung Hee University College of Medicine
Myeongcheol Lee: Kyung Hee University College of Medicine
Minji Kim: Kyung Hee University College of Medicine
Hyeon Jin Kim: Kyung Hee University College of Medicine
Seung Won Lee: Sungkyunkwan University School of Medicine
Sang Youl Rhee: Kyung Hee University College of Medicine
Ai Koyanagi: Parc Sanitari Sant Joan de Deu
Lee Smith: Anglia Ruskin University
Min Seo Kim: Broad Institute of MIT and Harvard
Hayeon Lee: Kyung Hee University College of Medicine
Jinseok Lee: Kyung Hee University
Dong Keon Yon: Kyung Hee University College of Medicine

Nature Communications, 2024, vol. 15, issue 1, 1-10

Abstract: Abstract As mounting evidence suggests a higher incidence of adverse consequences, such as disruption of the immune system, among patients with a history of COVID-19, we aimed to investigate post-COVID-19 conditions on a comprehensive set of allergic diseases including asthma, allergic rhinitis, atopic dermatitis, and food allergy. We used nationwide claims-based cohorts in South Korea (K-CoV-N; n = 836,164; main cohort) and Japan (JMDC; n = 2,541,021; replication cohort A) and the UK Biobank cohort (UKB; n = 325,843; replication cohort B) after 1:5 propensity score matching. Among the 836,164 individuals in the main cohort (mean age, 50.25 years [SD, 13.86]; 372,914 [44.6%] women), 147,824 were infected with SARS-CoV-2 during the follow-up period (2020−2021). The risk of developing allergic diseases, beyond the first 30 days of diagnosis of COVID-19, significantly increased (HR, 1.20; 95% CI, 1.13−1.27), notably in asthma (HR, 2.25; 95% CI, 1.80−2.83) and allergic rhinitis (HR, 1.23; 95% CI, 1.15−1.32). This risk gradually decreased over time, but it persisted throughout the follow-up period (≥6 months). In addition, the risk increased with increasing severity of COVID-19. Notably, COVID-19 vaccination of at least two doses had a protective effect against subsequent allergic diseases (HR, 0.81; 95% CI, 0.68−0.96). Similar findings were reported in the replication cohorts A and B. Although the potential for misclassification of pre-existing allergic conditions as incident diseases remains a limitation, ethnic diversity for evidence of incident allergic diseases in post-COVID-19 condition has been validated by utilizing multinational and independent population-based cohorts.

Date: 2024
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DOI: 10.1038/s41467-024-47176-w

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