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Acute corneal allograft rejection following SARS-CoV-2 vaccination: a systematic review

2023-02Journal article Open access
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dc.contributor.authorMoura‐Coelho, Nuno
dc.contributor.authorCunha, João Paulo
dc.contributor.authorPapa‐Vettorazzi, Renato
dc.contributor.authorGris, Óscar
dc.contributor.authorGüell, José Luis
dc.date.accessioned2022-07-20T09:27:35Z
dc.date.available2022-07-20T09:27:35Z
dc.date.issued2023-02
dc.description.abstractAll documented cases of acute corneal allograft rejection following SARS-CoV-2 vaccination were examined, to characterize possible risk factors and graft outcomes. Comprehensive search (4 electronic databases: PubMed, CENTRAL, ClinicalTrials.gov, Google Scholar, plus manual search in articles' reference lists) until March 1st, 2022 to identify studies reporting acute corneal allograft rejection following SARS-CoV-2 vaccination; study protocol was developed in line with PRISMA statement. We analysed demographics, allograft type, rejection prophylaxis regime at the time of vaccination, transplantation-to-vaccination time (G-Vt), vaccination-to-immune reaction onset time (V-Rt), management, best-corrected visual acuity before and after rejection, and graft survival. Of 169 titles/abstracts screened, 16 studies (n = 36 eyes) met the inclusion criteria. Fourteen eyes (38.9%) had received >1 graft, and 11.1% of cases had a history of immune reactions; 52.9% of cases occurred after the first dose. Median (P25-P75) G-Vt was 48 (10-78) months; median V-Rt was 9 (7-14) days. In eyes with resolved rejection, the median time-to-resolution was 3 (1-4) weeks. Four eyes (11.1%) had partial resolution of corneal decompensation, and 5 grafts (13.9%) failed. Acute corneal allograft rejection after SARS-CoV-2 vaccination is a rare event but may occur any time post-keratoplasty. Early recognition and prompt, aggressive treatment is warranted to optimize vision and graft survival. Well-known risk factors for rejection may be confounding factors, including the high proportion of cases with a history of previous grafts and the rejection prophylaxis regimes at the time of vaccination. Increasing immunosuppressants in the peri-vaccination period may decrease the risk of immune reactions, especially in high-risk cases.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationMoura-Coelho N, Cunha JP, Papa-Vettorazzi R, Gris O, Güell JL. Acute corneal allograft rejection following SARS-CoV-2 vaccination: a systematic review. Acta Ophthalmol. 2023;101(1):e1-13.pt_PT
dc.identifier.doi10.1111/aos.15211pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.21/14847
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWileypt_PT
dc.relation.publisherversionhttps://onlinelibrary.wiley.com/doi/10.1111/aos.15211pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectOphthalmologypt_PT
dc.subjectCOVID-19pt_PT
dc.subjectCoronaviruspt_PT
dc.subjectKeratoplastypt_PT
dc.subjectRejectionpt_PT
dc.subjectVaccinationpt_PT
dc.titleAcute corneal allograft rejection following SARS-CoV-2 vaccination: a systematic reviewpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPagee13pt_PT
oaire.citation.issue1pt_PT
oaire.citation.startPagee1pt_PT
oaire.citation.titleActa Ophthalmologicapt_PT
oaire.citation.volume101pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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