{"title":"The early impact of COVID-19 vaccines on major events in cardiac, pulmonary, and thromboembolic disease: a population-based study.","authors":"Myeong Geun Choi, Min-Ho Kim, Eun Mi Chun","doi":"10.3904/kjim.2025.056","DOIUrl":null,"url":null,"abstract":"<p><strong>Background/aims: </strong>Although COVID-19 vaccines reduce COVID-19 severity, various safety concerns have emerged. This study, involving a population-based cohort, used health insurance data to investigate potential vaccine-related major outcomes, including cardiac, pulmonary, and thromboembolic diseases.</p><p><strong>Methods: </strong>This retrospective cohort study involved data from 2,017,884 vaccinated (at least two doses) individuals and 334,583 unvaccinated individuals. The incidences of myocarditis, myocardial infarction, atrial fibrillation, interstitial lung disease, pulmonary thromboembolism, deep vein thrombosis, and cerebrovascular disease were compared between the vaccinated and the unvaccinated groups at 1 week to 3 months after vaccination.</p><p><strong>Results: </strong>The study population had a mean age of 54 years (male: 44.6%). Among the vaccinated, 57.7% received the mRNA vaccine only, whereas 35.5% received the adenoviral vector vaccine alone. Multivariate logistic analysis revealed that vaccination was significantly associated with the early development of myocarditis. The mRNA vaccine, a younger age, and retrohyperlipidemia were independent indicators of poor myocarditis prognosis after vaccination. However, the incidence of myocardial infarction at 1-2 weeks post-vaccination, as well as pulmonary thromboembolism and cerebrovascular disease (both at 3 months post-vaccination), were significantly lower in the vaccinated group when compared with the unvaccinated one. However, there was no significant association between vaccination and interstitial lung disease, atrial fibrillation, or deep vein thrombosis.</p><p><strong>Conclusion: </strong>The younger male population (age: < 45 years) should be cautious about receiving the COVID-19 mRNA vaccine and should be closely monitored for myocarditis after vaccination. Vaccination was associated with short-term protection against venous and arterial thrombotic events, as well as hemorrhagic events.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":" ","pages":"801-812"},"PeriodicalIF":2.4000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12425682/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Korean Journal of Internal Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3904/kjim.2025.056","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/26 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Background/aims: Although COVID-19 vaccines reduce COVID-19 severity, various safety concerns have emerged. This study, involving a population-based cohort, used health insurance data to investigate potential vaccine-related major outcomes, including cardiac, pulmonary, and thromboembolic diseases.
Methods: This retrospective cohort study involved data from 2,017,884 vaccinated (at least two doses) individuals and 334,583 unvaccinated individuals. The incidences of myocarditis, myocardial infarction, atrial fibrillation, interstitial lung disease, pulmonary thromboembolism, deep vein thrombosis, and cerebrovascular disease were compared between the vaccinated and the unvaccinated groups at 1 week to 3 months after vaccination.
Results: The study population had a mean age of 54 years (male: 44.6%). Among the vaccinated, 57.7% received the mRNA vaccine only, whereas 35.5% received the adenoviral vector vaccine alone. Multivariate logistic analysis revealed that vaccination was significantly associated with the early development of myocarditis. The mRNA vaccine, a younger age, and retrohyperlipidemia were independent indicators of poor myocarditis prognosis after vaccination. However, the incidence of myocardial infarction at 1-2 weeks post-vaccination, as well as pulmonary thromboembolism and cerebrovascular disease (both at 3 months post-vaccination), were significantly lower in the vaccinated group when compared with the unvaccinated one. However, there was no significant association between vaccination and interstitial lung disease, atrial fibrillation, or deep vein thrombosis.
Conclusion: The younger male population (age: < 45 years) should be cautious about receiving the COVID-19 mRNA vaccine and should be closely monitored for myocarditis after vaccination. Vaccination was associated with short-term protection against venous and arterial thrombotic events, as well as hemorrhagic events.
期刊介绍：
The Korean Journal of Internal Medicine is an international medical journal published in English by the Korean Association of Internal Medicine. The Journal publishes peer-reviewed original articles, reviews, and editorials on all aspects of medicine, including clinical investigations and basic research. Both human and experimental animal studies are welcome, as are new findings on the epidemiology, pathogenesis, diagnosis, and treatment of diseases. Case reports will be published only in exceptional circumstances, when they illustrate a rare occurrence of clinical importance. Letters to the editor are encouraged for specific comments on published articles and general viewpoints.
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