Risk of Corneal Transplant Rejection Following COVID-19 Vaccination: A Systematic Review and Meta-analysis

Parul Chawla Gupta; Bijaya K Padhi; Hashem Abu Serhan; Arkadiusz Dziedzic; Mahalaqua Nazli Khatib; Shilpa Gaidhane; Quazi Syed Zahiruddin; Abhay M Gaidhane; Neelima Kukreti; Sarvesh Rustagi; Prakasini Satapathy

doi:10.1007/s40123-024-00941-y

Risk of Corneal Transplant Rejection Following COVID-19 Vaccination: A Systematic Review and Meta-analysis

Ophthalmol Ther. 2024 Jun;13(6):1635-1645. doi: 10.1007/s40123-024-00941-y. Epub 2024 Apr 16.

Authors

Affiliations

¹ Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
² Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
³ Department of Ophthalmology, Hamad Medical Corporation, Doha, Qatar. habuserhan@hamad.qa.
⁴ Department of Conservative Dentistry with Endodontics, Medical University of Silesia, 40-055, Katowice, Poland.
⁵ Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India.
⁶ One Health Centre (COHERD), Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education, Wardha, India.
⁷ Division of Evidence Synthesis, Global Consortium of Public Health and Research, South Asia Infant Feeding Research Network (SAIFRN), Datta Meghe Institute of Higher Education, Wardha, India.
⁸ School of Epidemiology and Public Health, Jawaharlal Nehru Medical College, and Global Health Academy, Datta Meghe Institute of Higher Education, Wardha, India.
⁹ School of Pharmacy, Graphic Era Hill University, Dehradun, India.
¹⁰ School of Applied and Life Sciences, Uttaranchal University, Dehradun, Uttarakhand, India.
¹¹ Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.
¹² Medical Laboratories Techniques Department, AL-Mustaqbal University, Hillah, Babil, 51001, Iraq.

^# Contributed equally.

Abstract

Introduction: The COVID-19 pandemic has initiated an unparalleled global vaccination campaign, raising concerns about the vaccine's effects on various health conditions, including the risk of corneal transplant rejection. This systematic review aimed to identify the relationship between COVID-19 vaccination and rejection of corneal transplant, filling a significant gap in the existing medical literature.

Methods: A literature search was performed across multiple databases up to February 12, 2024, to identify studies evaluating the risk of corneal transplant rejection post-COVID-19 vaccination. Eligible studies were original research that reported outcomes of corneal graft rejection following vaccination. Nested Knowledge web software facilitated screening and data extraction. The Newcastle-Ottawa Scale was employed for quality assessment. A meta-analysis was conducted to calculate the aggregated relative risk (RR) utilizing R software version 4.3.

Results: Six studies were included in the qualitative synthesis, with four meeting the criteria for meta-analysis. These studies varied in geographic location, surgical techniques, and types of vaccines used. The pooled RR for corneal transplant rejection following COVID-19 vaccination was 0.816 (95% CI 0.178-1.453), indicating no significant risk of rejection. No statistical heterogeneity was observed among the studies (I² = 0%).

Conclusions: This review and meta-analysis found no significant evidence that COVID-19 vaccination increases the risk of corneal graft rejection. However, the current evidence is insufficient to conclusively determine the vaccine's safety for corneal transplant recipients. These findings underscore the need for additional research to confirm these preliminary results and investigate the long-term effects of COVID-19 vaccination on corneal transplants, aiming to provide evidence-based guidance to healthcare providers and patients.

Keywords: COVID-19 vaccine; Corneal transplantation; Meta-analysis; Ophthalmology; Systematic review.