Study finds low absolute risk of glomerular disease relapse associated with COVID-19 vaccination

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Several reports have described a relapse of certain autoimmune kidney diseases in patients after receiving COVID-19 vaccines, but it is unclear whether this association is real or coincidental. In a recent population-level study published in JASNthe researchers found that a second or third dose of the COVID-19 vaccine was associated with a higher relative risk, but a low absolute risk of relapse.

People with glomerular diseases, a group of autoimmune kidney diseases that often require long-term treatment with drugs that suppress the immune system, face a high risk of developing serious infections and are more likely to experience complications from infections such as COVID. . -19. As vaccination programs were implemented, individual case reports began to emerge describing outbreaks of glomerular disease that occurred within days to weeks after COVID-19 vaccinations, suggesting that the vaccine itself may have induced a flare of autoimmune kidney disease. These reports were very limited and, in the absence of a control population, were unable to provide precise estimates of the true risk of disease outbreak that may be associated with COVID-19 vaccines.

To provide clarity, a team led by Sean Barbour, MD, MSc (University of British Columbia) and Mark Canney, MD, PhD (University of Ottawa) studied information on all patients in British Columbia, Canada, who had the following glomerular diseases : chronic minima, focal segmental glomerulosclerosis, membranous nephropathy, IgA nephropathy, lupus nephritis, antineutrophil cytoplasmic antibody-related glomerulonephritis, and C3 glomerulonephritis. By capturing all patients with biopsy-confirmed glomerular disease in a centralized provincial database with link to both laboratory data and vaccination status over time, the researchers quantified the absolute and relative risk of disease relapse. glomerular disease after vaccination against COVID-19.

The analysis identified 1,105 adults with glomerular disease who were stable when COVID-19 vaccines first became available. During 281 days of follow-up, 134 patients (12.1%) relapsed. Although a first dose of vaccine was not associated with risk of relapse, exposure to a second or third dose was associated with a twofold relative risk of relapse; however, the absolute increase in risk of disease flare after these doses was still small, ranging from 1% to 5% depending on the type of glomerular disease. Most outbreaks of vaccine-associated illness were mild, with about 1 in 5 people needing some change in treatment.

“These results indicate that although COVID-19 vaccines may be associated with a small increased risk of causing a glomerular disease flare, this risk is very small and the well-established benefits of vaccination outweigh these risks,” he said. Dr. .Barbour. “This should encourage people with glomerular disease to continue receiving regular COVID-19 vaccinations. Our findings also suggest that people with glomerular disease should be carefully monitored after COVID-19 vaccinations for any early flare-up of their disease.

Dr. Barbour added that the study demonstrates how individual reports of vaccine side effects can create unnecessary anxiety and worry among people deciding whether to receive COVID-19 vaccines. Instead, proper studies need to be done to provide estimates of actual risk, so that people can be properly informed. “In this study, we confirmed initial reports of a possible complication of COVID-19 vaccines, however, we also showed that this risk is very small and the severity of the complication was quite mild,” said Dr. Barbour .

An accompanying editorial notes that the findings provide important information when looking at the advantage Y cons of COVID-19 vaccination with patients with glomerular disease.

Additional coauthors include Mohammad Atiquzzaman, PhD, Amanda M. Cunningham, MD, Yuyan Zheng, Master of Science, Lee Er, MSc, Steven Hawken, PhD, and Yinshan Zhao, PhD.

Font:

American Society of Nephrology

Journal references:

  1. Canney, M. and others. (2022). A population-based analysis of the risk of glomerular disease relapse after COVID-19 vaccination. Journal of the American Society of Nephrology. doi.org/10.1681/ASN.2022030258.
  2. Kronbichler, A & Anders, HJ., (2022) COVID-19 mRNA vaccines and their risk of inducing relapse of glomerular diseases. Journal of the American Society of Nephrology. doi.org/10.1681/ASN.2022091078.

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