Vogt-Koyanagi-Harada Disease and COVID

Abstract

Vogt–Koyanagi–Harada (VKH) is a rare multisystem inflammatory disease affecting the eyes, ears, brain, skin, and hair. The Coronavirus Disease 2019 (COVID-19) is a new contagious infection that might trigger the onset of VKH disease, as previously proposed for other viruses. Moreover, after the mass vaccination against SARS-CoV-2 worldwide, cases of VKH disease associated with COVID-19 vaccination have been reported. We present an overview of VKH and a comprehensive literature revision of all the VKH cases described after COVID-19 infection and vaccination, adding our experience. No differences have been found considering epidemiology and clinical findings of the disease compared to those reported in the no-COVID era. All of the patients promptly responded to systemic and local corticosteroid therapy with a good final visual prognosis. Different possible pathogenetic mechanisms underlying the onset of VKH after COVID-19 vaccination are discussed, while the presence of the HLA DR4 antigen as a genetic predisposition for the onset of the disease after COVID-19 infection and vaccination is proposed. VKH disease is one of the most frequently reported uveitic entities after COVID-19 vaccination, but a good response to therapy should not discourage vaccination. Nevertheless, ophthalmologists should be alerted to the possibility of VKH occurrence or relapse after COVID-19 vaccination, especially in genetically predisposed subjects.

Effect of the COVID-19 pandemic on Vogt–Koyanagi–Harada disease

“…In their study, Manni et al found no differences in the epidemiology or clinical findings of VKH disease between the COVID-19 and no-COVID-19 eras 27 . Furthermore, they also reported that all patients promptly responded to systemic and local corticosteroid therapy with a good final visual prognosis 27 .…”

“…In their study, Manni et al found no differences in the epidemiology or clinical findings of VKH disease between the COVID-19 and no-COVID-19 eras 27 . Furthermore, they also reported that all patients promptly responded to systemic and local corticosteroid therapy with a good final visual prognosis 27 . There were no significant differences with respect to important clinical features, such as visual prognosis, recurrence rates, SGF rates at 12 months, or type of VKH disease between before and after the declaration of a state of emergency.…”