COVID-19感染增加呼吸道2型炎症疾病风险，而疫苗接种具有保护作用
2026/03/04
摘要
背景：2019冠状病毒病（COVID-19）感染与疫苗接种对2型炎症性疾病的影响尚不明确。尽管病毒感染可导致免疫失调，但COVID-19感染及疫苗接种对各器官系统2型炎症性疾病的影响程度仍未得到充分研究。本研究旨在评估COVID-19感染和接种疫苗后新发2型炎症性疾病的风险。
方法：我们利用一个涵盖超过1.18亿患者的美国电子健康记录数据库，开展了一项大规模回顾性匹配队列研究。定义了三个队列：COVID-19感染者（n = 973,794）、COVID-19疫苗接种者（n = 691,270）和未暴露的对照组（n = 4,388,409）。通过倾向性评分匹配平衡人口统计学和临床协变量。我们计算了在3个月随访期内，新发哮喘、过敏性鼻炎、慢性鼻窦炎、特应性皮炎和嗜酸性粒细胞性食管炎的风险比（HR）。
结果：COVID-19感染显著增加了新发哮喘（HR 1.656，95% CI 1.590-1.725）、过敏性鼻炎（HR 1.272，95% CI 1.214-1.333）和慢性鼻窦炎（HR 1.744，95% CI 1.671-1.821）的风险。而特应性皮炎或嗜酸性粒细胞性食管炎的风险未见变化。相比之下，接种疫苗降低了新发哮喘（HR 0.678，95% CI 0.636-0.722）和慢性鼻窦炎（HR 0.799，95% CI 0.752-0.850）的风险。直接比较显示，与接种疫苗相比，感染导致呼吸系统2型炎症性疾病的风险高出2至3倍。
结论：COVID-19感染与呼吸系统2型炎症性疾病风险升高相关，而接种疫苗则具有保护作用。
COVID-19 infection raises respiratory type 2 inflammatory disease risk, whereas vaccination is protective
Olbrich, H., Preuß, S. L., Kridin, K., Hernandez, G., Thaçi, D., Ludwig, R. J., & Curman, P.
Abstract
Abstract
BACKGROUND:
Coronavirus disease 2019 (COVID-19) infection and vaccination have unclear impacts on type 2 inflammatory diseases. Although viral infections can drive immune dysregulation, the extent to which COVID-19 infection and vaccination affect type 2 inflammatory diseases in various organ systems remains underexplored. We sought to assess the risk of new-onset type 2 inflammatory diseases after COVID-19 infection and vaccination.
METHODS:
We conducted a large-scale retrospective matched cohort study using a US electronic health records database of more than 118 million patients. Three cohorts were defined: individuals with COVID-19 infection (n = 973,794), individuals with COVID-19 vaccination (n = 691,270), and unexposed controls (n = 4,388,409). Propensity score matching balanced demographic and clinical covariates. We calculated hazard ratios (HRs) for incident asthma, allergic rhinitis, chronic rhinosinusitis, atopic dermatitis, and eosinophilic esophagitis over 3-month follow-up.
RESULTS:
COVID-19 infection significantly increased the risks of asthma (HR 1.656, 95% CI 1.590-1.725), allergic rhinitis (HR 1.272, 95% CI 1.214-1.333), and chronic rhinosinusitis (HR 1.744, 95% CI 1.671-1.821). Risks for atopic dermatitis or eosinophilic esophagitis remained unchanged. In contrast, vaccination lowered the risks of asthma (HR 0.678, 95% CI 0.636-0.722) and chronic rhinosinusitis (HR 0.799, 95% CI 0.752-0.850). Direct comparison showed a 2- to 3-fold greater risk of respiratory type 2 inflammatory diseases with infection than with vaccination.
CONCLUSION:
COVID-19 infection is associated with a heightened risk of respiratory type 2 inflammatory diseases, whereas vaccination appears protective.
背景：2019冠状病毒病（COVID-19）感染与疫苗接种对2型炎症性疾病的影响尚不明确。尽管病毒感染可导致免疫失调，但COVID-19感染及疫苗接种对各器官系统2型炎症性疾病的影响程度仍未得到充分研究。本研究旨在评估COVID-19感染和接种疫苗后新发2型炎症性疾病的风险。
方法：我们利用一个涵盖超过1.18亿患者的美国电子健康记录数据库，开展了一项大规模回顾性匹配队列研究。定义了三个队列：COVID-19感染者（n = 973,794）、COVID-19疫苗接种者（n = 691,270）和未暴露的对照组（n = 4,388,409）。通过倾向性评分匹配平衡人口统计学和临床协变量。我们计算了在3个月随访期内，新发哮喘、过敏性鼻炎、慢性鼻窦炎、特应性皮炎和嗜酸性粒细胞性食管炎的风险比（HR）。
结果：COVID-19感染显著增加了新发哮喘（HR 1.656，95% CI 1.590-1.725）、过敏性鼻炎（HR 1.272，95% CI 1.214-1.333）和慢性鼻窦炎（HR 1.744，95% CI 1.671-1.821）的风险。而特应性皮炎或嗜酸性粒细胞性食管炎的风险未见变化。相比之下，接种疫苗降低了新发哮喘（HR 0.678，95% CI 0.636-0.722）和慢性鼻窦炎（HR 0.799，95% CI 0.752-0.850）的风险。直接比较显示，与接种疫苗相比，感染导致呼吸系统2型炎症性疾病的风险高出2至3倍。
结论：COVID-19感染与呼吸系统2型炎症性疾病风险升高相关，而接种疫苗则具有保护作用。
（中日友好医院呼吸与危重症医学科 沈焜路 摘译 林江涛 审校）
（J Allergy Clin Immunol. 2026 Feb; DOI: 10.1016/j.jaci.2025.07.030 ）
（J Allergy Clin Immunol. 2026 Feb; DOI: 10.1016/j.jaci.2025.07.030 ）
COVID-19 infection raises respiratory type 2 inflammatory disease risk, whereas vaccination is protective
Olbrich, H., Preuß, S. L., Kridin, K., Hernandez, G., Thaçi, D., Ludwig, R. J., & Curman, P.
Abstract
Abstract
BACKGROUND:
Coronavirus disease 2019 (COVID-19) infection and vaccination have unclear impacts on type 2 inflammatory diseases. Although viral infections can drive immune dysregulation, the extent to which COVID-19 infection and vaccination affect type 2 inflammatory diseases in various organ systems remains underexplored. We sought to assess the risk of new-onset type 2 inflammatory diseases after COVID-19 infection and vaccination.
METHODS:
We conducted a large-scale retrospective matched cohort study using a US electronic health records database of more than 118 million patients. Three cohorts were defined: individuals with COVID-19 infection (n = 973,794), individuals with COVID-19 vaccination (n = 691,270), and unexposed controls (n = 4,388,409). Propensity score matching balanced demographic and clinical covariates. We calculated hazard ratios (HRs) for incident asthma, allergic rhinitis, chronic rhinosinusitis, atopic dermatitis, and eosinophilic esophagitis over 3-month follow-up.
RESULTS:
COVID-19 infection significantly increased the risks of asthma (HR 1.656, 95% CI 1.590-1.725), allergic rhinitis (HR 1.272, 95% CI 1.214-1.333), and chronic rhinosinusitis (HR 1.744, 95% CI 1.671-1.821). Risks for atopic dermatitis or eosinophilic esophagitis remained unchanged. In contrast, vaccination lowered the risks of asthma (HR 0.678, 95% CI 0.636-0.722) and chronic rhinosinusitis (HR 0.799, 95% CI 0.752-0.850). Direct comparison showed a 2- to 3-fold greater risk of respiratory type 2 inflammatory diseases with infection than with vaccination.
CONCLUSION:
COVID-19 infection is associated with a heightened risk of respiratory type 2 inflammatory diseases, whereas vaccination appears protective.
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