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Int J Epidemiol . Relationship between shingles and coronavirus disease 2019: a self-controlled case series study

tetano

Editor, Senior Moderator
Int J Epidemiol


. 2025 Aug 18;54(5):dyaf162.
doi: 10.1093/ije/dyaf162. Relationship between shingles and coronavirus disease 2019: a self-controlled case series study

Tomoki Mizuno[SUP] 1 2 [/SUP], Jun Suzuki[SUP] 1 2 3 [/SUP], Shota Takahashi[SUP] 2 [/SUP], Haruka Imai[SUP] 1 2 3 [/SUP], Hideya Itagaki[SUP] 4 [/SUP], Tomohiro Akaba[SUP] 5 [/SUP], Makiko Yoshida[SUP] 2 3 6 [/SUP], Shiro Endo[SUP] 1 2 3 4 6 [/SUP]



Affiliations
Abstract

Background: Although some studies suggest an increased risk of shingles following coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, no research has examined this relationship in real-world clinical settings. We aimed to investigate the association between shingles and COVID-19 by using a Japanese inpatient and outpatient claims database.
Methods: We identified patients with COVID-19 from 1 January 2020 to 30 January 2023 by using a Japanese inpatient and outpatient claims database. We also identified those who developed shingles and received antiviral drugs within 90 days before or after their COVID-19 diagnosis. Using self-controlled case series methods, we evaluated the relationship between shingles and COVID-19. We calculated the incidence rate ratio (IRR) [95% confidence interval (CI)] for shingles during the buffer period (days -35 to -7), pre-exposure period (days -6 to 0), and risk periods of the first and second, third and fourth, and fifth and sixth weeks following COVID-19 infection compared with a control period outside these intervals.
Results: Among 399 381 patients with COVID-19, 558 were diagnosed with shingles. The IRR was significantly elevated during the first and second (5.1, 95% CI 3.9-6.6), third and fourth (1.7, 95% CI 1.2-2.5), and fifth and sixth weeks (1.5, 95% CI 1.0-2.3) compared with a control period.
Conclusion: This study of a Japanese inpatient and outpatient database reveals a relationship between shingles and COVID-19, indicating that shingles may be a characteristic of the virus and highlighting the need for varicella-zoster vaccination alongside SARS-CoV-2 in the COVID-19 era.

Keywords: COVID-19; SARS-CoV-2; database; pandemic; self-controlled case series design; shingles.

 
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