Epidemiology of Immune-Mediated Glomerulopathies before and after SARS-CoV-2 Vaccination: A Tertiary Referral Hospital Experience

Background: Vaccination is a known trigger for the appearance of immune-mediated glomerulopathies (IMG). The appearance of IMG after SARS-CoV-2 vaccination with suspected causality has been described. Our aim is to analyze the incidence of IMG flares before and after SARS-CoV-2 vaccination in our ce...

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Main Authors: Jorge Iván Zamora, Marina López-Martínez, Marc Patricio Liebana, Juan Carlos Leon Román, Sheila Bermejo, Ander Vergara, Irene Agraz, Natalia Ramos Terrades, Maria Antonieta Azancot, Nestor Toapanta, Maria Alejandra Gabaldon, Maria José Soler
Format: Article
Language:English
Published: MDPI AG 2023-03-01
Series:Journal of Clinical Medicine
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Online Access:https://www.mdpi.com/2077-0383/12/6/2420
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author Jorge Iván Zamora
Marina López-Martínez
Marc Patricio Liebana
Juan Carlos Leon Román
Sheila Bermejo
Ander Vergara
Irene Agraz
Natalia Ramos Terrades
Maria Antonieta Azancot
Nestor Toapanta
Maria Alejandra Gabaldon
Maria José Soler
author_facet Jorge Iván Zamora
Marina López-Martínez
Marc Patricio Liebana
Juan Carlos Leon Román
Sheila Bermejo
Ander Vergara
Irene Agraz
Natalia Ramos Terrades
Maria Antonieta Azancot
Nestor Toapanta
Maria Alejandra Gabaldon
Maria José Soler
author_sort Jorge Iván Zamora
collection DOAJ
description Background: Vaccination is a known trigger for the appearance of immune-mediated glomerulopathies (IMG). The appearance of IMG after SARS-CoV-2 vaccination with suspected causality has been described. Our aim is to analyze the incidence of IMG flares before and after SARS-CoV-2 vaccination in our center. Methods: All persons with native kidney biopsy (KB) from January 2019 to March 2022 in our center were included in the study. We compared the incidence of IMG before and after the start of vaccination. We also collected information about whether the patients had received a SARS-CoV-2 vaccine or have suffered from COVID in the six weeks before the IMG. We also evaluated the analytical characteristics of the outbreaks. Results: A total of 386 KB were studied. Of them, 86/218 (39.4%) were IMG performed pre- and 85/168 (50.6%) post-SV (029). The incidence of idiopathic nephrotic syndrome (INS), studied separately, was also significantly increased post-vaccination (<i>n</i> = 18 (10.7%)) compared to pre-vaccination (<i>n</i> = 11 (5%)) (<i>p</i> = 0.036). There were no differences in the incidence of vasculitis or IgA nephropathy. Up to 17 (20%) flares occurred 6 weeks before SARS-CoV-2 vaccination and only 2 (2.4%) within the first 6 weeks after SARS-CoV-2 infection. Within those 17 flares, the most common diagnosis was IgAN (<i>n</i> = 5 (29.4%)); a total of 14 (82.4%) received an mRNA vaccine and 9 (52.9%) took place after the 1st vaccine dose. There were 13 cases of minimal change disease (MCD) with debut/recurrence pre-SV and 20 MCD with debut/recurrence post-SV (<i>p</i> = 0.002). Conclusions: The incidence of IMG, INS and MCD flares in our center increased significantly after SARS-CoV-2 vaccination. Importantly, 20% of IMG flares took place within the first 6 weeks after receiving a vaccine dose, with the first dose being the riskiest one and IgAN the most frequent diagnosis.
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spelling doaj.art-bdb107e7e2be44c5874f466241a66f6e2023-11-17T11:52:36ZengMDPI AGJournal of Clinical Medicine2077-03832023-03-01126242010.3390/jcm12062420Epidemiology of Immune-Mediated Glomerulopathies before and after SARS-CoV-2 Vaccination: A Tertiary Referral Hospital ExperienceJorge Iván Zamora0Marina López-Martínez1Marc Patricio Liebana2Juan Carlos Leon Román3Sheila Bermejo4Ander Vergara5Irene Agraz6Natalia Ramos Terrades7Maria Antonieta Azancot8Nestor Toapanta9Maria Alejandra Gabaldon10Maria José Soler11Department of Nephrology, Vall d’Hebron University Hospital, 08035 Barcelona, SpainDepartment of Nephrology, Vall d’Hebron University Hospital, 08035 Barcelona, SpainDepartment of Nephrology, Vall d’Hebron University Hospital, 08035 Barcelona, SpainDepartment of Nephrology, Vall d’Hebron University Hospital, 08035 Barcelona, SpainDepartment of Nephrology, Vall d’Hebron University Hospital, 08035 Barcelona, SpainDepartment of Nephrology, Vall d’Hebron University Hospital, 08035 Barcelona, SpainDepartment of Nephrology, Vall d’Hebron University Hospital, 08035 Barcelona, SpainDepartment of Nephrology, Vall d’Hebron University Hospital, 08035 Barcelona, SpainDepartment of Nephrology, Vall d’Hebron University Hospital, 08035 Barcelona, SpainDepartment of Nephrology, Vall d’Hebron University Hospital, 08035 Barcelona, SpainCentro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud (CSUR), Vall d’Hebron University Hospital, 08036 Barcelona, SpainDepartment of Nephrology, Vall d’Hebron University Hospital, 08035 Barcelona, SpainBackground: Vaccination is a known trigger for the appearance of immune-mediated glomerulopathies (IMG). The appearance of IMG after SARS-CoV-2 vaccination with suspected causality has been described. Our aim is to analyze the incidence of IMG flares before and after SARS-CoV-2 vaccination in our center. Methods: All persons with native kidney biopsy (KB) from January 2019 to March 2022 in our center were included in the study. We compared the incidence of IMG before and after the start of vaccination. We also collected information about whether the patients had received a SARS-CoV-2 vaccine or have suffered from COVID in the six weeks before the IMG. We also evaluated the analytical characteristics of the outbreaks. Results: A total of 386 KB were studied. Of them, 86/218 (39.4%) were IMG performed pre- and 85/168 (50.6%) post-SV (029). The incidence of idiopathic nephrotic syndrome (INS), studied separately, was also significantly increased post-vaccination (<i>n</i> = 18 (10.7%)) compared to pre-vaccination (<i>n</i> = 11 (5%)) (<i>p</i> = 0.036). There were no differences in the incidence of vasculitis or IgA nephropathy. Up to 17 (20%) flares occurred 6 weeks before SARS-CoV-2 vaccination and only 2 (2.4%) within the first 6 weeks after SARS-CoV-2 infection. Within those 17 flares, the most common diagnosis was IgAN (<i>n</i> = 5 (29.4%)); a total of 14 (82.4%) received an mRNA vaccine and 9 (52.9%) took place after the 1st vaccine dose. There were 13 cases of minimal change disease (MCD) with debut/recurrence pre-SV and 20 MCD with debut/recurrence post-SV (<i>p</i> = 0.002). Conclusions: The incidence of IMG, INS and MCD flares in our center increased significantly after SARS-CoV-2 vaccination. Importantly, 20% of IMG flares took place within the first 6 weeks after receiving a vaccine dose, with the first dose being the riskiest one and IgAN the most frequent diagnosis.https://www.mdpi.com/2077-0383/12/6/2420immune-mediated glomerulopathyflarevaccineSARS-CoV-2
spellingShingle Jorge Iván Zamora
Marina López-Martínez
Marc Patricio Liebana
Juan Carlos Leon Román
Sheila Bermejo
Ander Vergara
Irene Agraz
Natalia Ramos Terrades
Maria Antonieta Azancot
Nestor Toapanta
Maria Alejandra Gabaldon
Maria José Soler
Epidemiology of Immune-Mediated Glomerulopathies before and after SARS-CoV-2 Vaccination: A Tertiary Referral Hospital Experience
Journal of Clinical Medicine
immune-mediated glomerulopathy
flare
vaccine
SARS-CoV-2
title Epidemiology of Immune-Mediated Glomerulopathies before and after SARS-CoV-2 Vaccination: A Tertiary Referral Hospital Experience
title_full Epidemiology of Immune-Mediated Glomerulopathies before and after SARS-CoV-2 Vaccination: A Tertiary Referral Hospital Experience
title_fullStr Epidemiology of Immune-Mediated Glomerulopathies before and after SARS-CoV-2 Vaccination: A Tertiary Referral Hospital Experience
title_full_unstemmed Epidemiology of Immune-Mediated Glomerulopathies before and after SARS-CoV-2 Vaccination: A Tertiary Referral Hospital Experience
title_short Epidemiology of Immune-Mediated Glomerulopathies before and after SARS-CoV-2 Vaccination: A Tertiary Referral Hospital Experience
title_sort epidemiology of immune mediated glomerulopathies before and after sars cov 2 vaccination a tertiary referral hospital experience
topic immune-mediated glomerulopathy
flare
vaccine
SARS-CoV-2
url https://www.mdpi.com/2077-0383/12/6/2420
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