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THE IMPACT OF THE COVID-19 PANDEMIC ON AUTOIMMUNE BULLOUS DISEASES: A RETROSPECTIVE ANALYSIS

Yıl 2026, Cilt: 27 Sayı: 1, 111 - 116, 12.01.2026
https://doi.org/10.18229/kocatepetip.1728056

Öz

OBJECTIVE: Autoimmune bullous diseases (AIBDs) are rare but potentially severe conditions characterized by an autoimmune response against structural proteins of the skin and mucosa, leading to significant morbidity and mortality. The COVID-19 (Coronavirus Disease 2019) pandemic represents a major global health crisis that may affect the immune system, potentially triggering or exacerbating autoimmune diseases. This study aims to evaluate the potential impact of COVID-19 on AIBDs by comparing the clinical characteristics, incidence, and treatment responses of patients diagnosed before and after the pandemic.
MATERIAL AND METHODS: Patients diagnosed with AIBDs at a university hospital between March 2016 and March 2024 were retrospectively analyzed. Demographic data, disease subtypes, clinical severity, treatment response, and hospitalization requirements were evaluated.
RESULTS: A total of 134 patients were included in the study, of whom 62 (46.3%) were diagnosed pre-pandemic and 72 (53.7%) post-pandemic. A significant increase in the incidence of bullous pemphigoid was observed in the post-pandemic period (59.7%, p=0.03). The incidence of AIBDs increased with age (p=0.02). Although no significant difference was found in disease severity, treatment-resistant cases were more frequently observed in the post-pandemic period.
CONCLUSIONS: Our study suggests that the COVID-19 pandemic may have contributed to an increased incidence of AIBDs, particularly in elderly individuals, and to the development of treatment resistance.

Etik Beyan

The study was granted ethical approval by the institutional review board (Approval No: B.30.2.ATA.0.01.00/381) and the hospital administration.

Kaynakça

  • 1. Rosi-Schumacher M, Baker J, Waris J, et al. Worldwide epidemiologic factors in pemphigus vulgaris and bullous pemphigoid. Front Immunol. 2023;14:1159351.
  • 2. Schmidt E, Kasperkiewicz M, Joly P. Pemphigus. Lancet. 2019;394(10201):882-94.
  • 3. D'Agostino GM, Rizzetto G, Marani A, et al.Bullous Pemphygoid and Novel Therapeutic Approaches. Biomedicines. 2022;10(11):2844.
  • 4. Gjersvik PJ, Rønnevig JR. Dermatitis herpetiformis [Dermatitis herpetiformis]. Tidsskr Nor Laegeforen. 2003;123(22):3234-6.
  • 5. Onyeaka H, Anumudu CK, Al-Sharify ZT, et al. COVID-19 pandemic: A review of the global lockdown and its far-reaching effects. Sci Prog. 2021;104(2):368504211019854.
  • 6. Hussein HM, Rahal EA. The role of viral infections in the development of autoimmune diseases. Crit Rev Microbiol. 2019;45(4):394-412.
  • 7. Curman P, Kridin K, Zirpel H, et al. COVID-19 infection is associated with an elevated risk for autoimmune blistering diseases while COVID-19 vaccination decreases the risk: A large-scale population-based cohort study of 112 million individuals. J Am Acad Dermatol. 2025;92(3):452-63.
  • 8. Martora F, Battista T, Potestio L, et al. Pemphigus and Bullous Pemphigoid Following COVID-19 Vaccination: A Systematic Review. Viruses. 2024;16(12):1896.
  • 9. Uzun S, Durdu M, Kaya Tİ, Aktan Ş, editors. Otoimmün Büllöz Hastalıklar. 1st ed. İstanbul: Türk Dermatoloji Derneği Yayınları. 2017.
  • 10. Tesch F, Ehm F, Vivirito A, et al. Incident autoimmune diseases in association with SARS-CoV-2 infection: a matched cohort study. Clin Rheumatol. 2023;42(10):2905-14.
  • 11. Moghadam FS, Kianfar N, Dasdar S, et al. Adverse outcome and severity of COVID-19 in patients with autoimmune bullous diseases: A historical cohort study. Dermatol Ther. 2022;35(9):e15672.
  • 12. Smatti MK, Cyprian FS, Nasrallah GK, et al. Viruses and Autoimmunity: A Review on the Potential Interaction and Molecular Mechanisms. Viruses. 2019;11(8):762.
  • 13. Inokuchi S, Shimamoto K. Persistent Risk of Developing Autoimmune Diseases Associated With COVID-19: An Observational Study Using an Electronic Medical Record Database in Japan. J Clin Rheumatol. 2024;30(2):65- 72.
  • 14. Heo YW, Jeon JJ, Ha MC, et al. Long-Term Risk of Autoimmune and Autoinflammatory Connective Tissue Disorders Following COVID-19. JAMA Dermatol. 2024;160(12):1278-87.
  • 15. Mahmood F, Cyr J, Li A, et al. Vesiculobullous and Other Cutaneous Manifestations of COVID-19 Vaccines: A Scoping and Narrative Review. J Cutan Med Surg. 2023;27(3):260-70.
  • 16. Birabaharan M, Kaelber DC, Orme CM, et al. Evaluating risk of bullous pemphigoid after mRNA COVID-19 vaccination. Br J Dermatol. 2022;187(2):271-3.
  • 17. De Martino M, Chiappini E, Galli L. Vaccines and autoimmunity. Int J Immunopathol Pharmacol. 2013;26(2):283-90.
  • 18. Olivieri B, Betterle C, Zanoni G. Vaccinations and autoimmune diseases. Vaccines (Basel). 2021;9(8):815.
  • 19. Krammer F. The human antibody response to influenza A virüs infection and vaccination. Nat Rev Immunol. 2019;19(6):383-97.
  • 20. Sonmezer MC, Sahin TK, Erul E, et al. Knowledge, Attitudes, and Perception towards COVID-19 Vaccination among the Adult Population: A Cross-Sectional Study in Turkey. Vaccines (Basel). 2022;10(2):278.
  • 21. Wang Y, Dong C, Han Y, et al. Immunosenescence, aging and successful aging. Front Immunol. 2022;13:942796.
  • 22. Rosato E, Salsano F. Immunity, autoimmunity and autoimmune diseases in older people. J Biol Regul Homeost Agents. 2008;22(4):217-24.
  • 23. Mishra N, Kammer GM. Clinical expression of autoimmune diseases in older adults. Clin Geriatr Med. 1998;14(3):515-42.
  • 24. Müller L, Di Benedetto S. From aging to long COVID: exploring the convergence of immunosenescence, inflammaging, and autoimmunity. Front Immunol. 2023;14:1298004.

COVID-19 PANDEMİSİNİN OTOİMMÜN BÜLLÖZ HASTALIKLAR ÜZERİNDEKİ ETKİSİ: RETROSPEKTİF BİR ANALİZ

Yıl 2026, Cilt: 27 Sayı: 1, 111 - 116, 12.01.2026
https://doi.org/10.18229/kocatepetip.1728056

Öz

AMAÇ: Otoimmün büllöz hastalıklar (OBH) cilt ve mukozanın yapısal proteinlerine karşı otoimmün bir yanıtla karakterize edilen nadir ancak potansiyel olarak ciddi durumlar olup önemli morbidite ve mortaliteye yol açar. COVID-19 (Koronavirüs Hastalığı 2019) pandemisi, bağışıklık sistemini etkileyebilen ve potansiyel olarak otoimmün hastalıkları tetikleyebilen veya kötüleştirebilen büyük bir küresel sağlık krizini temsil etmektedir. Bu çalışmada, pandemi öncesi ve sonrası dönemde OBH tanısı alan hastaların klinik özellikleri, insidansı ve tedavi yanıtları karşılaştırılarak, COVID-19’un OBH üzerindeki olası etkilerinin değerlendirilmesi amaçlanmıştır.
GEREÇ VE YÖNTEM: Mart 2016 - Mart 2024 tarihleri arasında bir üniversite hastanesinde OBH tanısı alan hastalar retrospektif olarak incelendi. Demografik veriler, hastalık alt tipleri, klinik şiddet, tedavi yanıtı ve hastaneye yatış gereksinimleri değerlendirildi.
BULGULAR: Çalışmaya toplam 134 hasta dahil edildi; bunlardan 62'si (%46,3) pandemi öncesi, 72'si (%53,7) pandemi sonrası teşhis edildi. Pandemi sonrası dönemde büllöz pemfigoid insidansında anlamlı bir artış gözlendi (%59,7, p=0,03). Otoimmün büllöz hastalıkların insidansı yaşla birlikte artış gösterdi. (p=0,02). Hastalığın şiddetinde anlamlı bir fark bulunmamasına rağmen, pandemi sonrası dönemde tedaviye dirençli vakalar daha sık görüldü.
SONUÇ: Çalışmamız, COVID-19 pandemisinin özellikle yaşlı bireylerde OBH insidansının artmasına ve tedavi direncinin gelişmesine sebep olabileceğini düşündürmektedir.

Kaynakça

  • 1. Rosi-Schumacher M, Baker J, Waris J, et al. Worldwide epidemiologic factors in pemphigus vulgaris and bullous pemphigoid. Front Immunol. 2023;14:1159351.
  • 2. Schmidt E, Kasperkiewicz M, Joly P. Pemphigus. Lancet. 2019;394(10201):882-94.
  • 3. D'Agostino GM, Rizzetto G, Marani A, et al.Bullous Pemphygoid and Novel Therapeutic Approaches. Biomedicines. 2022;10(11):2844.
  • 4. Gjersvik PJ, Rønnevig JR. Dermatitis herpetiformis [Dermatitis herpetiformis]. Tidsskr Nor Laegeforen. 2003;123(22):3234-6.
  • 5. Onyeaka H, Anumudu CK, Al-Sharify ZT, et al. COVID-19 pandemic: A review of the global lockdown and its far-reaching effects. Sci Prog. 2021;104(2):368504211019854.
  • 6. Hussein HM, Rahal EA. The role of viral infections in the development of autoimmune diseases. Crit Rev Microbiol. 2019;45(4):394-412.
  • 7. Curman P, Kridin K, Zirpel H, et al. COVID-19 infection is associated with an elevated risk for autoimmune blistering diseases while COVID-19 vaccination decreases the risk: A large-scale population-based cohort study of 112 million individuals. J Am Acad Dermatol. 2025;92(3):452-63.
  • 8. Martora F, Battista T, Potestio L, et al. Pemphigus and Bullous Pemphigoid Following COVID-19 Vaccination: A Systematic Review. Viruses. 2024;16(12):1896.
  • 9. Uzun S, Durdu M, Kaya Tİ, Aktan Ş, editors. Otoimmün Büllöz Hastalıklar. 1st ed. İstanbul: Türk Dermatoloji Derneği Yayınları. 2017.
  • 10. Tesch F, Ehm F, Vivirito A, et al. Incident autoimmune diseases in association with SARS-CoV-2 infection: a matched cohort study. Clin Rheumatol. 2023;42(10):2905-14.
  • 11. Moghadam FS, Kianfar N, Dasdar S, et al. Adverse outcome and severity of COVID-19 in patients with autoimmune bullous diseases: A historical cohort study. Dermatol Ther. 2022;35(9):e15672.
  • 12. Smatti MK, Cyprian FS, Nasrallah GK, et al. Viruses and Autoimmunity: A Review on the Potential Interaction and Molecular Mechanisms. Viruses. 2019;11(8):762.
  • 13. Inokuchi S, Shimamoto K. Persistent Risk of Developing Autoimmune Diseases Associated With COVID-19: An Observational Study Using an Electronic Medical Record Database in Japan. J Clin Rheumatol. 2024;30(2):65- 72.
  • 14. Heo YW, Jeon JJ, Ha MC, et al. Long-Term Risk of Autoimmune and Autoinflammatory Connective Tissue Disorders Following COVID-19. JAMA Dermatol. 2024;160(12):1278-87.
  • 15. Mahmood F, Cyr J, Li A, et al. Vesiculobullous and Other Cutaneous Manifestations of COVID-19 Vaccines: A Scoping and Narrative Review. J Cutan Med Surg. 2023;27(3):260-70.
  • 16. Birabaharan M, Kaelber DC, Orme CM, et al. Evaluating risk of bullous pemphigoid after mRNA COVID-19 vaccination. Br J Dermatol. 2022;187(2):271-3.
  • 17. De Martino M, Chiappini E, Galli L. Vaccines and autoimmunity. Int J Immunopathol Pharmacol. 2013;26(2):283-90.
  • 18. Olivieri B, Betterle C, Zanoni G. Vaccinations and autoimmune diseases. Vaccines (Basel). 2021;9(8):815.
  • 19. Krammer F. The human antibody response to influenza A virüs infection and vaccination. Nat Rev Immunol. 2019;19(6):383-97.
  • 20. Sonmezer MC, Sahin TK, Erul E, et al. Knowledge, Attitudes, and Perception towards COVID-19 Vaccination among the Adult Population: A Cross-Sectional Study in Turkey. Vaccines (Basel). 2022;10(2):278.
  • 21. Wang Y, Dong C, Han Y, et al. Immunosenescence, aging and successful aging. Front Immunol. 2022;13:942796.
  • 22. Rosato E, Salsano F. Immunity, autoimmunity and autoimmune diseases in older people. J Biol Regul Homeost Agents. 2008;22(4):217-24.
  • 23. Mishra N, Kammer GM. Clinical expression of autoimmune diseases in older adults. Clin Geriatr Med. 1998;14(3):515-42.
  • 24. Müller L, Di Benedetto S. From aging to long COVID: exploring the convergence of immunosenescence, inflammaging, and autoimmunity. Front Immunol. 2023;14:1298004.
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Dermatoloji
Bölüm Araştırma Makalesi
Yazarlar

Zeynep Karaca Ural 0000-0002-3333-7027

Zeynep Utlu 0000-0002-0178-2871

Merve Hatun Erkayman 0000-0002-9230-2190

Handan Bilen 0000-0001-6507-1406

Feyza Çatal 0009-0004-7869-6885

Gönderilme Tarihi 26 Haziran 2025
Kabul Tarihi 10 Eylül 2025
Yayımlanma Tarihi 12 Ocak 2026
Yayımlandığı Sayı Yıl 2026 Cilt: 27 Sayı: 1

Kaynak Göster

APA Karaca Ural, Z., Utlu, Z., Erkayman, M. H., … Bilen, H. (2026). THE IMPACT OF THE COVID-19 PANDEMIC ON AUTOIMMUNE BULLOUS DISEASES: A RETROSPECTIVE ANALYSIS. Kocatepe Tıp Dergisi, 27(1), 111-116. https://doi.org/10.18229/kocatepetip.1728056
AMA Karaca Ural Z, Utlu Z, Erkayman MH, Bilen H, Çatal F. THE IMPACT OF THE COVID-19 PANDEMIC ON AUTOIMMUNE BULLOUS DISEASES: A RETROSPECTIVE ANALYSIS. KTD. Ocak 2026;27(1):111-116. doi:10.18229/kocatepetip.1728056
Chicago Karaca Ural, Zeynep, Zeynep Utlu, Merve Hatun Erkayman, Handan Bilen, ve Feyza Çatal. “THE IMPACT OF THE COVID-19 PANDEMIC ON AUTOIMMUNE BULLOUS DISEASES: A RETROSPECTIVE ANALYSIS”. Kocatepe Tıp Dergisi 27, sy. 1 (Ocak 2026): 111-16. https://doi.org/10.18229/kocatepetip.1728056.
EndNote Karaca Ural Z, Utlu Z, Erkayman MH, Bilen H, Çatal F (01 Ocak 2026) THE IMPACT OF THE COVID-19 PANDEMIC ON AUTOIMMUNE BULLOUS DISEASES: A RETROSPECTIVE ANALYSIS. Kocatepe Tıp Dergisi 27 1 111–116.
IEEE Z. Karaca Ural, Z. Utlu, M. H. Erkayman, H. Bilen, ve F. Çatal, “THE IMPACT OF THE COVID-19 PANDEMIC ON AUTOIMMUNE BULLOUS DISEASES: A RETROSPECTIVE ANALYSIS”, KTD, c. 27, sy. 1, ss. 111–116, 2026, doi: 10.18229/kocatepetip.1728056.
ISNAD Karaca Ural, Zeynep vd. “THE IMPACT OF THE COVID-19 PANDEMIC ON AUTOIMMUNE BULLOUS DISEASES: A RETROSPECTIVE ANALYSIS”. Kocatepe Tıp Dergisi 27/1 (Ocak2026), 111-116. https://doi.org/10.18229/kocatepetip.1728056.
JAMA Karaca Ural Z, Utlu Z, Erkayman MH, Bilen H, Çatal F. THE IMPACT OF THE COVID-19 PANDEMIC ON AUTOIMMUNE BULLOUS DISEASES: A RETROSPECTIVE ANALYSIS. KTD. 2026;27:111–116.
MLA Karaca Ural, Zeynep vd. “THE IMPACT OF THE COVID-19 PANDEMIC ON AUTOIMMUNE BULLOUS DISEASES: A RETROSPECTIVE ANALYSIS”. Kocatepe Tıp Dergisi, c. 27, sy. 1, 2026, ss. 111-6, doi:10.18229/kocatepetip.1728056.
Vancouver Karaca Ural Z, Utlu Z, Erkayman MH, Bilen H, Çatal F. THE IMPACT OF THE COVID-19 PANDEMIC ON AUTOIMMUNE BULLOUS DISEASES: A RETROSPECTIVE ANALYSIS. KTD. 2026;27(1):111-6.

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