COVID-19が喘息リスクを高めるがワクチンが保護(COVID-19 linked to increased asthma risk – vaccine offers protection)

2025-08-15

2025-08-14 カロリンスカ研究所(KI)

Karolinska Institutetの研究で、COVID-19感染は気管支喘息や慢性副鼻腔炎、花粉症などタイプ2炎症性疾患の発症リスクを高める可能性が示された。米国の電子カルテデータ(感染者約97万人、ワクチン接種者約69万人、非感染・非接種者約438万人)を解析した結果、感染者は非感染者より喘息66%、副鼻腔炎74%、花粉症27%高リスクだった。一方、ワクチン接種者は非感染者より喘息リスクが32%低く、他の疾患リスクも低下傾向にあった。感染者と接種者を比較すると、感染者は喘息・副鼻腔炎で2倍以上、花粉症で40%高いリスクを示した。本研究は因果関係を断定できないが、COVID-19が気道の炎症性疾患リスクを高め、ワクチンが予防的効果を持つ可能性があると結論づけた。成果はThe Journal of Allergy and Clinical Immunologyに掲載。

<関連情報>

COVID-19感染は呼吸器系2型炎症性疾患のリスクを高める一方、ワクチン接種は保護効果を示す COVID-19 infection raises respiratory type-2 inflammatory disease risk, whereas vaccination is protective

Henning Olbrich, MD ∙ Sophie L. Preuß, MD ∙ Khalaf Kridin, MD, PhD ∙ … ∙ Diamant Thaçi, MD ∙ Ralf J. Ludwig, MD ∙ Philip Curman, MD, PhD
The Journal of Allergy and Clinical Immunology Published:August 12, 2025
DOI:https://doi.org/10.1016/j.jaci.2025.07.030

ABSTRACT

Background

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.

Objective

We aimed 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 within a United States electronic health records database of over 118 million patients. Three cohorts were defined: individuals with COVID-19 infection (973,794), individuals with COVID-19 vaccination (691,270), and unexposed controls (4,388,409). Propensity-score matching balanced demographic and clinical covariates. We calculated hazard ratios for incident asthma, allergic rhinitis, chronic rhinosinusitis, atopic dermatitis, and eosinophilic esophagitis over a three-month follow-up.

Results

COVID-19 infection significantly increased the risks of asthma (hazard ratio 1.656, 95% confidence interval 1.590–1.725), allergic rhinitis (1.272, 1.214–1.333), and chronic rhinosinusitis (1.744, 1.671–1.821). Risks for atopic dermatitis or eosinophilic esophagitis remained unchanged. In contrast, vaccination lowered the risks of asthma (0.678, 0.636–0.722) and chronic rhinosinusitis (0.799, 0.752–0.850). Direct comparison showed a two- to threefold greater risk of respiratory type-2 inflammatory diseases with infection than with vaccination.