Autoimmune Sequelae After Delta or Omicron Variant SARS-CoV-2 Infection in a Highly Vaccinated Cohort
Authors' conclusion
This cohort study observed no significantly elevated long-term risk of autoimmune sequelae after SARS-CoV-2 Delta and Omicron BA.1 or BA.2 variant infection, except for a modestly increased risk of inflammatory bowel disease and bullous skin disorders in the hospitalized subgroup during the predominance of the Omicron variant.
Study context
- Population
- Adults ≥18 years in Singapore, highly vaccinated, with SARS-CoV-2 infection during Delta and Omicron BA.1/BA.2 predominance, alive at 30 days after diagnosis; enrolled September 1, 2021, to March 7, 2022915,096 females [51.9%]
- Participants
- 1,766,036 adults
- Exposure
- SARS-CoV-2 Delta or Omicron BA.1/BA.2 infection vs contemporaneous test-negative controls
- Casesn = 480,082
- Controlsn = 1,285,954reference
- Outcome
- New-incident autoimmune diagnoses (MediClaims national claims database), 31 to 300 days after index date
- Follow-up
- 300 days
Methodological detailsnational registry-based, overlap-weighted Cox proportional hazards regression, contemporary uninfected control group
- National registry-based
- Overlap-weighted Cox proportional hazards regression
- Contemporary uninfected control group
Main finding
As reported in the abstract
12 prespecified autoimmune sequelae
- No significantly elevated risk of 12 prespecified autoimmune sequelae across the Omicron and Delta variant cohorts
Observational data: associations, not effects.
Further findings
| Outcome | aHR (95% CI) | P value | |
|---|---|---|---|
| IBD, hospitalized COVID-19 cases during Omicron predominance (subgroup) | 2.23 (1.45–3.46) | P < 0.001 | |
| Bullous skin disorders, hospitalized COVID-19 cases during Omicron predominance (subgroup) | 4.88 (2.47–9.66) | P < 0.001 | |
| Vasculitis, vaccine-breakthrough Omicron infections (subgroup) | 5.74 (1.48–22.23) | P = 0.01 | |
| 0.050.21520Adjusted hazard ratio (log scale) |
Vasculitis, vaccine-breakthrough Omicron infections (subgroup)
- No increased risk of vasculitis in the corresponding subgroup who received boosters
Original publication
Autoimmune Sequelae After Delta or Omicron Variant SARS-CoV-2 Infection in a Highly Vaccinated Cohort. JAMA Netw Open. Published 1 August 2024. doi:10.
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