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Subsequent COVID-19 Prophylaxis in COVID-19 Associated Glomerulopathies
Therese Boyle1,2, Emma O'Lone2,3, Elaine Phua3
1Department of Clinical Immunology and Allergy, Royal North Shore Hospital, St Leonards, Sydney, NSW 2065, Australia.
Vaccines
|July 29, 2023
Summary
COVID-19 vaccination is linked to a rise in anti-GBM disease, but subsequent vaccinations appear safe. Antibody testing may guide prophylaxis needs for patients with vaccine-associated glomerulonephritis.
Area of Science:
- Nephrology
- Immunology
- Infectious Diseases
Background:
- The COVID-19 pandemic continues to impact global health, with emerging reports of glomerular diseases linked to both infection and vaccination.
- A notable increase in anti-GBM disease (glomerulonephritis) has been observed, necessitating further investigation into its management.
Purpose of the Study:
- To review anti-GBM antibody detection rates over five years.
- To investigate the incidence and outcomes of anti-GBM disease following COVID-19 vaccination.
- To assess the safety of subsequent COVID-19 vaccinations in affected patients.
Main Methods:
- Retrospective review of anti-GBM antibody detection rates.
- Case follow-up of three patients with biopsy-confirmed glomerulonephritis temporally related to COVID-19 vaccination.
- Assessment of COVID-19 antibody levels and outcomes after subsequent vaccinations.
Main Results:
- A three-fold increase in significant anti-GBM antibody results was observed, with 25% associated with COVID-19 vaccination.
- Subsequent COVID-19 vaccination in three patients did not result in adverse effects or disease relapse.
- Two of three patients showed positive COVID-19 antibody levels despite immunosuppression.
Conclusions:
- There is an observed rise in anti-GBM antibody disease incidence potentially linked to COVID-19 vaccination.
- COVID-19 antibody testing may aid in determining prophylaxis requirements.
- Alternative vaccine types appear safe for subsequent vaccination in patients with vaccine-associated glomerulonephritis.
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