tetano
Editor, Senior Moderator
Vaccine
. 2025 Dec 1:70:128017.
doi: 10.1016/j.vaccine.2025.128017. Online ahead of print. Severe COVID-19, vaccination, and mortality among individuals with asthma: A Nationwide population-based cohort study
Sang Hyuk Kim[SUP] 1 [/SUP], Min Gu Kang[SUP] 2 [/SUP], Jong Geol Jang[SUP] 3 [/SUP], Youlim Kim[SUP] 4 [/SUP], Ji-Yong Moon[SUP] 4 [/SUP], Kyung Hoon Min[SUP] 5 [/SUP], Jong Seung Kim[SUP] 6 [/SUP], Hyun Lee[SUP] 7 [/SUP]
Affiliations
Background: Severe coronavirus disease 2019 (COVID-19) often results in worse outcomes, including mortality, in individuals with asthma compared to those without the lung disease. However, it remains uncertain whether COVID-19 vaccination improves long-term mortality in individuals with asthma.
Methods: Using the Korean National Health Insurance System database, individuals with asthma were classified into four groups based on COVID-19 vaccination and COVID-19 infection status: vaccinated/uninfected, vaccinated/infected, unvaccinated/uninfected, and unvaccinated/infected individuals. After 1:1:1:1 propensity score matching, 3384 individuals with asthma were included. The primary outcome was all-cause mortality. Two multivariable models were employed: Model 1 used the unvaccinated/infected group as the reference, while Model 2 used the unvaccinated/uninfected group as the reference.
Results: Over a median follow-up duration of 350 days (interquartile ranges, 294-407 days), the mortality rate was highest in the unvaccinated/infected individuals (3481 per 10,000 person-years) and lowest in the vaccinated/uninfected individuals (94 per 10,000 person-years). In Model 1, among individuals with severe COVID-19, prior COVID-19 vaccination was associated with a 61 % reduction in mortality (hazard ratio
: 0.39, 95 % confidence interval [CI]: 0.31-0.50). The risk of mortality was further decreased among uninfected individuals (HR: 0.15, 95 % CI: 0.10-0.21 for unvaccinated/uninfected individuals; HR: 0.04, 95 % CI: 0.02-0.07 for vaccinated/uninfected individuals). In Model 2, among uninfected individuals, COVID-19 vaccination exhibited a 74 % reduction in mortality risk (HR: 0.26; 95 % CI: 0.13-0.52), whereas individuals experiencing severe COVID-19 had markedly elevated mortality risks (HR: 2.69, 95 % CI: 1.84-3.92 for vaccinated/infected individuals and HR: 6.85, 95 % CI: 4.86-9.67 for unvaccinated/infected individuals).
Conclusions: The COVID-19 vaccination was associated with reduced long-term mortality in individuals with asthma, regardless of COVID-19 status.
Keywords: Asthma; COVID-19; Mortality; Vaccination.
. 2025 Dec 1:70:128017.
doi: 10.1016/j.vaccine.2025.128017. Online ahead of print. Severe COVID-19, vaccination, and mortality among individuals with asthma: A Nationwide population-based cohort study
Sang Hyuk Kim[SUP] 1 [/SUP], Min Gu Kang[SUP] 2 [/SUP], Jong Geol Jang[SUP] 3 [/SUP], Youlim Kim[SUP] 4 [/SUP], Ji-Yong Moon[SUP] 4 [/SUP], Kyung Hoon Min[SUP] 5 [/SUP], Jong Seung Kim[SUP] 6 [/SUP], Hyun Lee[SUP] 7 [/SUP]
Affiliations
- PMID: 41330187
- DOI: 10.1016/j.vaccine.2025.128017
Background: Severe coronavirus disease 2019 (COVID-19) often results in worse outcomes, including mortality, in individuals with asthma compared to those without the lung disease. However, it remains uncertain whether COVID-19 vaccination improves long-term mortality in individuals with asthma.
Methods: Using the Korean National Health Insurance System database, individuals with asthma were classified into four groups based on COVID-19 vaccination and COVID-19 infection status: vaccinated/uninfected, vaccinated/infected, unvaccinated/uninfected, and unvaccinated/infected individuals. After 1:1:1:1 propensity score matching, 3384 individuals with asthma were included. The primary outcome was all-cause mortality. Two multivariable models were employed: Model 1 used the unvaccinated/infected group as the reference, while Model 2 used the unvaccinated/uninfected group as the reference.
Results: Over a median follow-up duration of 350 days (interquartile ranges, 294-407 days), the mortality rate was highest in the unvaccinated/infected individuals (3481 per 10,000 person-years) and lowest in the vaccinated/uninfected individuals (94 per 10,000 person-years). In Model 1, among individuals with severe COVID-19, prior COVID-19 vaccination was associated with a 61 % reduction in mortality (hazard ratio
: 0.39, 95 % confidence interval [CI]: 0.31-0.50). The risk of mortality was further decreased among uninfected individuals (HR: 0.15, 95 % CI: 0.10-0.21 for unvaccinated/uninfected individuals; HR: 0.04, 95 % CI: 0.02-0.07 for vaccinated/uninfected individuals). In Model 2, among uninfected individuals, COVID-19 vaccination exhibited a 74 % reduction in mortality risk (HR: 0.26; 95 % CI: 0.13-0.52), whereas individuals experiencing severe COVID-19 had markedly elevated mortality risks (HR: 2.69, 95 % CI: 1.84-3.92 for vaccinated/infected individuals and HR: 6.85, 95 % CI: 4.86-9.67 for unvaccinated/infected individuals).
Conclusions: The COVID-19 vaccination was associated with reduced long-term mortality in individuals with asthma, regardless of COVID-19 status.
Keywords: Asthma; COVID-19; Mortality; Vaccination.