Long-term recurrence interval of Vogt–Koyanagi–Harada disease post-COVID-19 vaccination: A case study (preprint)

Purpose This study aimed to report a case of Vogt–Koyanagi–Harada (VKH) disease that recurred 46 years after initial treatment; the recurrence occurred 2 months after the third dose of coronavirus disease 2019 vaccination.Case report: A 59-year-old female patient had bilateral blurring for 2 months; she received her third dose of coronavirus disease 2019 vaccine 4 months before the onset of blurring. The best-corrected visual acuity was 1.0 in the right eye and 0.15 he left eye at the initial visit. Iritis and synechia between lens and iris were observed bilaterally. Sunset glow fundus was found in both eyes with no serous retinal detachments or disk hyperemia. She had a history of VKH disease and was treated with whole-body corticosteroid administration at another hospital when she was 13 years old. She was diagnosed with VKH disease recurrence, and oral corticosteroid intake and corticosteroid eyedrop treatments were initiated. The treatment response was good, but left synechia remained between the lens and iris in the left eye. Recurrence was not observed for 10 months until this study, and her best-corrected visual acuity was 1.0 in both eyes.Conclusion To our knowledge, this case represents the longest recorded interval of VKH disease recurrence in the literature.

COVID-19 Hospitalizations, Intensive Care Unit Stays, Ventilation, and Death Among Patients With Immune-mediated Inflammatory Diseases Compared to Controls.

OBJECTIVE: To investigate coronavirus disease 2019 (COVID-19) hospitalization risk in patients with immune-mediated inflammatory diseases (IMIDs) compared with matched non-IMID comparators from the general population. METHODS: We conducted a population-based, matched cohort study using health administrative data from January to July 2020 in Ontario, Canada. Cohorts for each of the following IMIDs were assembled: rheumatoid arthritis (RA), psoriasis, psoriatic arthritis (PsA), ankylosing spondylitis, systemic autoimmune rheumatic diseases (SARDs), multiple sclerosis (MS), iritis, inflammatory bowel disease, polymyalgia rheumatica, and vasculitis. Each patient was matched with 5 non-IMID comparators based on sociodemographic factors. We compared the cumulative incidence of hospitalizations for COVID-19 and their outcomes between IMID and non-IMID patients. RESULTS: A total of 493,499 patients with IMID (417 hospitalizations) and 2,466,946 non-IMID comparators (1519 hospitalizations) were assessed. The odds of being hospitalized for COVID-19 were significantly higher in patients with IMIDs compared with their matched non-IMID comparators (matched unadjusted odds ratio [OR] 1.37, adjusted OR 1.23). Significantly higher risk of hospitalizations was found in patients with iritis (OR 1.46), MS (OR 1.83), PsA (OR 2.20), RA (OR 1.42), SARDs (OR 1.47), and vasculitis (OR 2.07). COVID-19 hospitalizations were associated with older age, male sex, long-term care residence, multimorbidity, and lower income. The odds of complicated hospitalizations were 21% higher among all IMID vs matched non-IMID patients, but this association was attenuated after adjusting for demographic factors and comorbidities. CONCLUSION: Patients with IMIDs were at higher risk of being hospitalized with COVID-19. This risk was explained in part by their comorbidities.