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[A possible relationship between anti-SARS-CoV-2 vaccination and glomerular diseases: food for thought for the
Manuela Rizzo1, Antonella Marino2, Anna Sannino2
1Dipartimento di Medicina, Chirurgia e Odontoiatria, Università degli Studi di Salerno, Salerno, Italy.
Abstract:
In order to fight the SARS-CoV-2 pandemic, mass-vaccination programs have been launched globally starting December 2020. The pace of COVID-19 vaccines development was impressive and although data from clinical trials and post-authorization studies showed acceptable safety profile, additional studies and long-term population-level surveillance are needed. A possible link between all type of vaccination and immunological diseases is perhaps one of the hottest topics in literature; correspondingly, there is growing concern over the small but growing number of case reports linking COVID-19 vaccines with the development of glomerular disease. Our group conducted a systematic review of such cases. Results showed that IgA nephropathy (IgAN) and Minimal Change Disease (MCD) are the most frequently associated glomerulopathies. Interestingly, IgAN cases are mostly flares occurring few hours after the second dose of RNA vaccines and have a good clinical outcome, while both de novo and recurring MCD can occur up to 28 days after the first or second dose of vaccines. RNA vaccines are the most common vaccine type to be associated with glomerulopathy. Of course, this may simply reflect the more widespread use of these vaccines. However, compared to traditional vaccines, they do seem produce a higher antibody response and a stronger CD8+ T- and CD4+ T-cell response, including higher production of chemokines and cytokines.
Insights
COVID-19 vaccines, particularly RNA vaccines, have been linked to rare cases of glomerular disease, including IgA nephropathy and Minimal Change Disease. Most cases show good outcomes, but continued surveillance is recommended.
Area of Science:
- Nephrology
- Immunology
- Vaccinology
Background:
- Global mass vaccination campaigns for SARS-CoV-2 began in December 2020.
- While COVID-19 vaccines demonstrate an acceptable safety profile, ongoing surveillance is crucial.
- Emerging case reports suggest a potential link between COVID-19 vaccines and glomerular diseases.
Purpose of the Study:
- To systematically review case reports linking COVID-19 vaccines to glomerular disease.
- To identify the types of glomerulopathies and vaccines most frequently associated with these conditions.
- To analyze the clinical outcomes and temporal associations of vaccine-induced glomerulopathies.
Main Methods:
- Systematic review of published case reports.
- Analysis of glomerulopathy types, vaccine types, and clinical outcomes.
- Comparison of associations between RNA vaccines and traditional vaccines.
Main Results:
- Immunoglobulin A nephropathy (IgAN) and Minimal Change Disease (MCD) were the most frequently reported glomerulopathies.
- IgAN cases often presented as flares hours after the second RNA vaccine dose with good outcomes.
- MCD (de novo or recurrent) occurred up to 28 days post-vaccination (first or second dose).
- RNA vaccines were most commonly associated, potentially due to widespread use and stronger immune responses.
Conclusions:
- COVID-19 vaccination, especially with RNA vaccines, is associated with rare instances of IgAN and MCD.
- These vaccine-associated glomerulopathies generally have favorable clinical outcomes.
- Further population-level surveillance is necessary to fully understand long-term effects and risks.
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