Background: COVID-19 has been linked to prolonged immune dysfunction and long-term health complications. Herpes zoster (HZ), a marker of impaired cell-mediated immunity, may signal increased vulnerability to infections, cardiovascular disease, and potentially cancer. However, its association with colorectal cancer (CRC) after COVID-19 has not been fully explored. Objective: To investigate the long-term risks of cardiovascular events, acute respiratory failure, sepsis, and CRC in COVID-19 survivors who developed HZ compared to those who did not. Methods: We conducted a retrospective cohort study using the TriNetX Global Collaborative Network. Adults diagnosed with COVID-19 between January 2020 and January 2022 were included. Among the full cohort (aged ≥18 years), 27,664 patients with post-COVID HZ were identified. Due to platform limitations, propensity score matching (PSM) was applied to a restricted subgroup of patients aged 55–60 years, yielding a 1:1 matched cohort for controlled comparisons. Outcomes were assessed over a three-year follow-up. Results: In the matched age-restricted cohort, patients with post-COVID HZ had significantly higher risks of cardiovascular events, acute respiratory failure, sepsis, and CRC compared to matched controls. Subgroup analyses identified age ≥ 50, chronic kidney disease, diabetes, and hypertension as strong independent risk factors across outcomes. Despite the low absolute CRC incidence, cancer-free survival significantly favored the non-HZ group. Conclusion: Herpes zoster reactivation after COVID-19 is associated with increased risk of colorectal cancer. Enhanced surveillance and early CRC screening may benefit this high-risk population.
背景：COVID-19与持续的免疫功能紊乱及长期健康并发症相关。带状疱疹作为细胞免疫功能受损的标志，可能提示个体对感染、心血管疾病乃至癌症的易感性增加。然而，其在COVID-19后与结直肠癌的关联尚未得到充分探讨。目的：比较COVID-19康复后发生带状疱疹与未发生带状疱疹的患者，评估其长期心血管事件、急性呼吸衰竭、脓毒症及结直肠癌的发生风险。方法：本研究基于TriNetX全球协作网络开展回顾性队列研究，纳入2020年1月至2022年1月期间确诊的成年COVID-19患者。在全队列（年龄≥18岁）中，共识别出27,664例COVID-19后带状疱疹患者。受平台数据限制，研究对55-60岁年龄段的患者亚组进行倾向评分匹配，形成1:1匹配队列以进行对照比较，并对所有患者开展为期三年的结局随访。结果：在年龄限制的匹配队列中，COVID-19后带状疱疹患者发生心血管事件、急性呼吸衰竭、脓毒症及结直肠癌的风险均显著高于匹配对照组。亚组分析显示，年龄≥50岁、慢性肾脏病、糖尿病和高血压是所有结局事件的强独立危险因素。尽管结直肠癌绝对发病率较低，但无癌生存率在非带状疱疹组显著更优。结论：COVID-19后带状疱疹的再激活与结直肠癌风险升高相关。加强监测和早期结直肠癌筛查可能使这一高危人群获益。
肿瘤(癌症)患者之家