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Disclosures: Bhavsar is employed by GlaxoSmithKline. Please see the study for all other authors’ relevant financial disclosures.
April 03, 2022
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Older adults with COVID-19 have significantly increased risk for herpes zoster

Disclosures: Bhavsar is employed by GlaxoSmithKline. Please see the study for all other authors’ relevant financial disclosures.
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People aged 50 years or older with COVID-19 had a 15% increased risk for developing herpes zoster, according to the results of a large retrospective cohort study.

“The COVID-19 pandemic has exposed how vulnerable older adults are to infectious diseases. During the pandemic, we saw several case reports published describing development of herpes zoster (HZ) following COVID-19,” Amit B. Bhavsar, MBBS, MHA, senior clinical research development lead at GlaxoSmithKline, told Healio.

IDN0422Bhavsar_Graphic_01_WEB
Bhavsar A, et al. Open Forum Infect Dis. 2022;doi:10.1093/ofid/ofac118.

“Most of the patients in these reports developed HZ within 1 to 2 weeks of COVID-19,” Bhavsar said. “These case reports hypothesized that COVID-19-induced dysfunction of cell-mediated immunity leads to reactivation of herpes zoster. However, as we know, case reports constitute [a] low level of association.”

For their study, Bhavsar and colleagues used two large U.S. insurance databases to evaluate if there is an association between COVID-19 and HZ. They enrolled adults aged 50 or older with COVID-19 and matched them in a 1:4 ratio to people without COVID-19 by age, sex, presence of HZ risk factors and health care cost level.

In total, 394,677 people with COVID-19 were matched with 1,577,346 people without COVID-19. The data demonstrated that individuals diagnosed with COVID-19 had a 15% higher HZ risk than those without COVID-19 (adjusted incidence rate ratio [IRR] = 1.15; 95% CI, 1.07-1.24). Additionally, they found that the increased HZ risk was 21% higher following COVID-19 hospitalization (aIRR = 1.21, 95% CI, 1.03-1.41).

“It is important that health care professionals are aware of this potential increased risk so patients can be diagnosed and treated early if they develop shingles following COVID-19,” Bhavsar said. “These results also highlight the importance of preventive measures, such as vaccination, to protect the health and well-being of older adults who are at risk for vaccine-preventable diseases like COVID-19 and shingles.