빅데이터를 이용한 COVID-19 백신 접종 후 발생한 안과적 이상사례에 대한 고찰
Use of Big Data to Evaluate Adverse Ophthalmic Adverse Events after COVID-19 Vaccination
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목적: 본 연구는 대한민국 울산지역의 유일한 상급 종합병원에 COVID-19 백신 접종 후 안과적 이상사례가 발생하여 내원한 환자들의이상사례의 종류 및 빈도에 대해 조사하여 백신과의 연관성에 대해 분석하였다. 대상과 방법: 2021년 3월부터 2022년 8월까지 COVID-19 백신 접종 후 울산대병원에 내원한 안과적 불편감이 발생하여 내원한 환자들에 대한 후향적 단면 연구이다. 관련된 임상 자료는 울산대학교병원의 전자 의무기록과 임상데이터 수집 플랫폼에서 수집되었다. 결과: 연구일 기준 울산시에서 총 2,766,569회의 COVID-19 백신 접종이 이루어 졌고 본원에서 총 확인된 안과적 이상사례는 97건이며, 21건은 비가역적인 후유증이 남았다. 발생시기는 접종 후 1주일 이내에 나타났으며(평균: 5.06 ± 6.86일), 가장 흔한 증상은 시력저하이며(67건), 안구통증(19건), 복시(16건) 순이다. 비가역적으로 진행된 경우 밝혀진 원인 질환으로 뇌졸중과 같은 뇌신경 질환(7건), 망막 질환(5건), 녹내장(5건) 순이다. 이상사례 유발 백신 빈도는 BNT162b2가 가장 높으며(34건), ChAdOx1 (30건), mRNA-1273 (20건), Ad26.COV2.S (4건) 순이다. 결론: COVID-19 백신은 다른 백신과 달리 긴급하게 승인되었고, 백신 접종 후 안과적 이상은 거의 알려져 있지 않았다. COVID-19 백신 접종 후의 안과적 이상사례는 드물지만, 비가역적인 후유증을 유발할 수 있으므로 주의 깊게 모니터링되어야 한다.
Abstract
Purpose: This study explored the types and incidences of adverse ophthalmic adverse events after COVID-19 vaccination and their associations with such vaccination in patients who presented to the sole local, tertiary, general hospital in region Ulsan of South Korea complaining of ophthalmic discomfort after COVID-19 vaccination. Methods: This cross-sectional study was conducted at Ulsan University Hospital, which is the only tertiary general hospital in Ulsan city. All participants visited the hospital from March 2021 to August 2022 complaining of ophthalmic discomfort after COVID-19 vaccination. Clinical variables were collected from both our clinical data warehouse and the electronic medical records of the hospital. Results: To date, 2,766,569 COVID-19 vaccine doses have been administered in Ulsan city. A total of 97 cases of vaccination-related adverse ophthalmic events have been confirmed. In 21 of these cases, irreversible sequelae persisted after the side-effects. Most symptoms developed within 1 week after vaccination (mean 5.06 ± 6.86 days). The most common symptom was visual disturbance (67 cases), followed by ocular pain (19 cases) and double vision (16 cases). The most frequent diagnoses associated with irreversible sequelae were neurological diseases (7 cases), retinal diseases (5 cases), and glaucoma (5 cases). The frequencies of side effects were highest for those of BNT162b2 status (34 cases), followed by those of ChAdOx1 (30), mRNA-1273 (20), and Ad26.COV2.S (4). Conclusions: In contrast to other vaccinations, COVID-19 vaccination was viewed as urgent; a few known ophthalmic side effects developed after vaccination. Although such adverse events are rare, affected patients must be closely monitored; the sequelae may be irreversible.
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