Acute Endothelial Graft Rejection Following COVID-19 Infection

Behera, Geeta; Gokhale, Tanmay; Babu, K Ramesh

doi:10.7759/cureus.19084

Cited by 6 publications

(18 citation statements)

References 10 publications

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“…After the exclusion of duplicates and articles that did not fulfill the study inclusion criteria, fifty-two articles were included in the qualitative synthesis of this systematic review. The reports of ninety-six cases (fiftysix organ rejection cases following COVID-19 vaccination [7][8][9][10][11] and forty organ rejection cases after COVID-19 infection [12][13][14][15][16][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60]) identified from these articles are presented in groups based on confirmed diagnoses, laboratory, biopsy and imaging findings. The detailed characteristics of the included studies are shown in Tables 1 and 2.…”

Section: Study Characteristics and Qualitymentioning

confidence: 99%

“…Cells in the anterior chamber There were 42 case reports [5][6][7][8][11][12][13]17,18,[20][21][22][24][25][26][27][29][30][31][32][33][34][35][37][38][39][40][41][42][43][44][45][48][49][50][51][52][53][54][55][56][57], 8 case series [9,10,14,28,36,46,47,58] and 2 cohort studies [19,23]. These studies were conducted in t...…”

Section: Study Characteristics and Qualitymentioning

confidence: 99%

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Solid Organ Rejection following SARS-CoV-2 Vaccination or COVID-19 Infection: A Systematic Review and Meta-Analysis

et al. 2022

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Background: Solid organ rejection post-SARS-CoV-2 vaccination or COVID-19 infection is extremely rare but can occur. T-cell recognition of antigen is the primary and central event that leads to the cascade of events that result in rejection of a transplanted organ. Objectives: To describe the results of a systematic review for solid organ rejections following SARS-CoV-2 vaccination or COVID-19 infection. Methods: For this systematic review and meta-analysis, we searched Proquest, Medline, Embase, Pubmed, CINAHL, Wiley online library, Scopus and Nature through the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines for studies on the incidence of solid organ rejection post-SARS-CoV-2 vaccination or COVID-19 infection, published from 1 December 2019 to 31 May 2022, with English language restriction. Results: One hundred thirty-six cases from fifty-two articles were included in the qualitative synthesis of this systematic review (56 solid organs rejected post-SARS-CoV-2 vaccination and 40 solid organs rejected following COVID-19 infection). Cornea rejection (44 cases) was the most frequent organ observed post-SARS-CoV-2 vaccination and following COVID-19 infection, followed by kidney rejection (36 cases), liver rejection (12 cases), lung rejection (2 cases), heart rejection (1 case) and pancreas rejection (1 case). The median or mean patient age ranged from 23 to 94 years across the studies. The majority of the patients were male (n = 51, 53.1%) and were of White (Caucasian) (n = 51, 53.7%) and Hispanic (n = 15, 15.8%) ethnicity. A total of fifty-six solid organ rejections were reported post-SARS-CoV-2 vaccination [Pfizer-BioNTech (n = 31), Moderna (n = 14), Oxford Uni-AstraZeneca (n = 10) and Sinovac-CoronaVac (n = 1)]. The median time from SARS-CoV-2 vaccination to organ rejection was 13.5 h (IQR, 3.2–17.2), while the median time from COVID-19 infection to organ rejection was 14 h (IQR, 5–21). Most patients were easily treated without any serious complications, recovered and did not require long-term allograft rejection therapy [graft success (n = 70, 85.4%), graft failure (n = 12, 14.6%), survived (n = 90, 95.7%) and died (n = 4, 4.3%)]. Conclusion: The reported evidence of solid organ rejections post-SARS-CoV-2 vaccination or COIVD-19 infection should not discourage vaccination against this worldwide pandemic. The number of reported cases is relatively small in relation to the hundreds of millions of vaccinations that have occurred, and the protective benefits offered by SARS-CoV-2 vaccination far outweigh the risks.

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Section: Study Characteristics and Qualitymentioning

confidence: 99%

Section: Study Characteristics and Qualitymentioning

confidence: 99%

Solid Organ Rejection following SARS-CoV-2 Vaccination or COVID-19 Infection: A Systematic Review and Meta-Analysis

et al. 2022

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“…Twenty-four articles were identified through the database search on 13 February 2022 [ 20 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 ]. After reviewing the titles and abstracts of the 24 articles, 10 were excluded based on the article type (letter to the editor and review) [ 44 , 47 ], corneal graft rejection after COVID-19 [ 45 , 46 , 48 , 50 ], eye banking issues during the COVID-19 pandemic [ 42 , 49 ], and other unrelated topics [ 43 , 51 ]. Fourteen articles were selected for full-text screening, and one was excluded because of the lack of clinical history [ 20 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ].…”

Section: Resultsmentioning

confidence: 99%

Characteristics and Clinical Ocular Manifestations in Patients with Acute Corneal Graft Rejection after Receiving the COVID-19 Vaccine: A Systematic Review

Fujio

Sung

Nakatani

et al. 2022

JCM

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This study aimed to determine the characteristics and clinical ocular manifestations of acute corneal graft rejection after coronavirus disease 2019 (COVID-19) vaccination. We conducted an online search of the PubMed and EMBASE databases. Data on recipients’ characteristics, corneal transplantation types, interval between vaccination and allograft rejection, clinical manifestations, and graft rejection medication were extracted. Thirteen articles on 21 patients (23 eyes) with acute corneal graft rejection after COVID-19 vaccination, published between April and December 2021, were included. The median (interquartile range) age at the onset of rejection was 68 (27–83) years. Types of transplantation included penetrating keratoplasty (12 eyes), Descemet membrane endothelial keratoplasty (six eyes), Descemet stripping automated endothelial keratoplasty (four eyes), and living-related conjunctival-limbal allograft (one eye). The interval between vaccination and rejection ranged from 1 day to 6 weeks. Corneal edema was the leading clinical manifestation (20 eyes), followed by keratic precipitates (14 eyes) and conjunctival or ciliary injection (14 eyes). Medications included frequently applied topical corticosteroids (12 eyes), followed by a combination of topical and oral corticosteroids (four eyes). In addition, the clinical characteristics of corneal allograft rejection after COVID-19 vaccination were identified. Corneal transplant recipients may require further vaccination, necessitating appropriate management and treatment.

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“…Another important limitation is that the number of publications on acute rejection after SARS‐CoV‐2 vaccination exceeds by far the number of reports of keratoplasty patients developing corneal allograft rejection after other vaccines; while this is possibly due to increased awareness of the potential of immunization‐induced immune reactions on corneal grafts, it is also possible that the novelty of the viral agent and the novelty of the mRNA vaccines raised a potential publication bias. We emphasize our belief that the benefits of SARS‐CoV‐2 vaccination far outweigh the potential risks of acute corneal allograft rejection following vaccination, considering the potentially severe complications of COVID‐19 disease, and considering the potential ocular manifestations of COVID‐19 (Cunha et al, 2020 ), which may also include acute corneal graft rejection (Ang et al, 2020 ; Behera et al, 2021 ; Jin & Juthani, 2020 ; Singh & Mathur, 2021 ). Most corneal surgeons agree with this policy, according to a recent survey of 142 corneal surgeons (Lockington et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Acute corneal allograft rejection following SARS‐CoV‐2 vaccination–A systematic review

Moura-Coelho

Cunha

Papa-Vettorazzi

et al. 2022

Acta Ophthalmologica

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Coronavirus disease , the ongoing pandemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is still a major public health challenge. The rapid development of a number of vaccines for SARS-CoV-2 was crucial for the prevention of severe manifestations of the disease and death due to COVID-19. SARS-CoV-2 has the potential to affect many tissues and systems, including ocular tissues and adnexa. (Cunha et al., 2020;Lin et al., 2021) The watchful control of adverse events (AEs) of the novel vaccines also led to the detection of rare ocular AEs after SARS-CoV-2 vaccination affecting any ocular structure and the optic nerve. (

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Acute Endothelial Graft Rejection Following COVID-19 Infection

Cited by 6 publications

References 10 publications

Solid Organ Rejection following SARS-CoV-2 Vaccination or COVID-19 Infection: A Systematic Review and Meta-Analysis

Solid Organ Rejection following SARS-CoV-2 Vaccination or COVID-19 Infection: A Systematic Review and Meta-Analysis

Characteristics and Clinical Ocular Manifestations in Patients with Acute Corneal Graft Rejection after Receiving the COVID-19 Vaccine: A Systematic Review

Acute corneal allograft rejection following SARS‐CoV‐2 vaccination–A systematic review

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