| Effects of Vaccination on Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Nationwide Population-Based Cohort Study |
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Sang Hyuk Kim1,2, Hyun Lee3, Min Ji Kim4,5, Min Gu Kang4,5, Jong Seung Kim4,5,6, Jong Geol Jang7, Youlim Kim8, Hyeon-Kyoung Koo9, Chin Kook Rhee10, Kyung Hoon Min2, Yong Il Hwang11, Deog Kyeom Kim12, Yong Bum Park13, Ji-Yong Moon8, on behalf of the Korean COPD Study Group |
1Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine, Gyeongju, Republic of Korea
2Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
3Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang Medical Center, Hanyang University College of Medicine, Seoul, Republic of Korea
4Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju, Republic of Korea
5Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
6Department of Otorhinolaryngology-Head and Neck Surgery, Jeonbuk National University Medical School, Jeonju, Republic of Korea
7Division of Pulmonology and Allergy, Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Republic of Korea
8Division of Pulmonary and Allergy, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
9Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
10Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
11Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
12Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
13Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Republic of Korea |
Correspondence:
Yong Bum Park, Tel: +82-2-2225-2754, Fax: +82-2-2224-2569,
Email: bfspark2@gmail.com
Ji-Yong Moon, Tel: +82-2-2030-7524, Fax: +82-2-2030-7748,
Email: respiry@gmail.com
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Received: 5 December 2024 • Revised: 31 January 2025 • Accepted: 24 February 2025
*Sang Hyuk Kim and Hyun Lee contributed equally to this study as co-first authors. |
| Abstract |
Background
Coronavirus 2019 (COVID-19) vaccination appears to have potential benefits for patients with chronic obstructive pulmonary disease (COPD). However, limited information is available on whether COVID-19 vaccination reduces acute exacerbation of COPD (AECOPD).
Methods
In the present study, 41,606 individuals with COPD were enrolled using the Korean National Health Insurance System-severe acute respiratory syndrome coronavirus 2 (NHIS SARS-CoV-2) database from 2020–2021. A total of 3,602 individuals were included in the analytical cohort through 1:1 propensity score (PS) matching between vaccinated and unvaccinated individuals. The risk of AECOPD was assessed using a Cox proportional hazards regression analysis. A post hoc analysis assessed the impact of COVID-19 on AECOPD in vaccinated and unvaccinated individuals, adjusting for differences between infected and uninfected groups.
Results
During the study period, the incidence of exacerbation was lower in vaccinated individuals (1,683/10,000 PY) than in unvaccinated individuals (3,410/10,000 PY). In the Cox proportional hazards regression model, the risk of AECOPD was significantly lower in vaccinated individuals compared to unvaccinated individuals (hazard ratio [HR) = 0.55, 95% confidence interval [CI] = 0.41–0.72). In the post hoc analysis, COVID-19 was associated with an increased risk of AECOPD among unvaccinated individuals after adjustment (adjusted HR = 2.06, 95% CI = 1.28–3.33). In contrast, among vaccinated individuals, the risk of AECOPD did not differ significantly between those infected and uninfected with COVID-19 (adjusted HR = 1.35, 95% CI = 0.42–4.36).
Conclusion
COVID-19 vaccination may reduce the risk of AECOPD in individuals with COPD. |
| Key Words:
chronic obstructive pulmonary disease, respiratory disease, vaccination, COVID-19, exacerbation, vaccination recommendation |
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