A Population-Based Analysis of the Risk of Glomerular Disease Relapse after COVID-19 Vaccination
Copyright © 2022 by the American Society of Nephrology..
BACKGROUND: Although case reports have described relapses of glomerular disease after COVID-19 vaccination, evidence of a true association is lacking. In this population-level analysis, we sought to determine relative and absolute risks of glomerular disease relapse after COVID-19 vaccination.
METHODS: In this retrospective population-level cohort study, we used a centralized clinical and pathology registry (2000-2020) to identify 1105 adult patients in British Columbia, Canada, with biopsy-proven glomerular disease that was stable on December 14, 2020 (when COVID-19 vaccines first became available). The primary outcome was disease relapse, on the basis of changes in kidney function, proteinuria, or both. Vaccination was modeled as a 30-day time-varying exposure in extended Cox regression models, stratified on disease type.
RESULTS: During 281 days of follow-up, 134 (12.1%) patients experienced a relapse. Although a first vaccine dose was not associated with relapse risk (hazard ratio [HR]=0.67; 95% confidence interval [95% CI], 0.33 to 1.36), exposure to a second or third dose was associated with a two-fold risk of relapse (HR=2.23; 95% CI, 1.06 to 4.71). The pattern of relative risk was similar across glomerular diseases. The absolute increase in 30-day relapse risk associated with a second or third vaccine dose varied from 1%-2% in ANCA-related glomerulonephritis, minimal change disease, membranous nephropathy, or FSGS to 3%-5% in IgA nephropathy or lupus nephritis. Among 24 patients experiencing a vaccine-associated relapse, 4 (17%) had a change in immunosuppression, and none required a biopsy.
CONCLUSIONS: In a population-level cohort of patients with glomerular disease, a second or third dose of COVID-19 vaccine was associated with higher relative risk but low absolute increased risk of relapse.
| Errataetall: |
CommentIn: J Am Soc Nephrol. 2022 Dec;33(12):2128-2131. - PMID 36332972 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:33 |
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| Enthalten in: |
Journal of the American Society of Nephrology : JASN - 33(2022), 12 vom: 04. Dez., Seite 2247-2257 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Canney, Mark [VerfasserIn] |
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| Links: |
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| Themen: |
COVID-19 |
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| Anmerkungen: |
Date Completed 02.12.2022 Date Revised 02.12.2023 published: Print-Electronic CommentIn: J Am Soc Nephrol. 2022 Dec;33(12):2128-2131. - PMID 36332972 Citation Status MEDLINE |
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| doi: |
10.1681/ASN.2022030258 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 2 | |a A Population-Based Analysis of the Risk of Glomerular Disease Relapse after COVID-19 Vaccination |
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| 500 | |a CommentIn: J Am Soc Nephrol. 2022 Dec;33(12):2128-2131. - PMID 36332972 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 by the American Society of Nephrology. | ||
| 520 | |a BACKGROUND: Although case reports have described relapses of glomerular disease after COVID-19 vaccination, evidence of a true association is lacking. In this population-level analysis, we sought to determine relative and absolute risks of glomerular disease relapse after COVID-19 vaccination | ||
| 520 | |a METHODS: In this retrospective population-level cohort study, we used a centralized clinical and pathology registry (2000-2020) to identify 1105 adult patients in British Columbia, Canada, with biopsy-proven glomerular disease that was stable on December 14, 2020 (when COVID-19 vaccines first became available). The primary outcome was disease relapse, on the basis of changes in kidney function, proteinuria, or both. Vaccination was modeled as a 30-day time-varying exposure in extended Cox regression models, stratified on disease type | ||
| 520 | |a RESULTS: During 281 days of follow-up, 134 (12.1%) patients experienced a relapse. Although a first vaccine dose was not associated with relapse risk (hazard ratio [HR]=0.67; 95% confidence interval [95% CI], 0.33 to 1.36), exposure to a second or third dose was associated with a two-fold risk of relapse (HR=2.23; 95% CI, 1.06 to 4.71). The pattern of relative risk was similar across glomerular diseases. The absolute increase in 30-day relapse risk associated with a second or third vaccine dose varied from 1%-2% in ANCA-related glomerulonephritis, minimal change disease, membranous nephropathy, or FSGS to 3%-5% in IgA nephropathy or lupus nephritis. Among 24 patients experiencing a vaccine-associated relapse, 4 (17%) had a change in immunosuppression, and none required a biopsy | ||
| 520 | |a CONCLUSIONS: In a population-level cohort of patients with glomerular disease, a second or third dose of COVID-19 vaccine was associated with higher relative risk but low absolute increased risk of relapse | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a COVID-19 | |
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| 650 | 4 | |a recurrence | |
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| 700 | 1 | |a Atiquzzaman, Mohammad |e verfasserin |4 aut | |
| 700 | 1 | |a Cunningham, Amanda M |e verfasserin |4 aut | |
| 700 | 1 | |a Zheng, Yuyan |e verfasserin |4 aut | |
| 700 | 1 | |a Er, Lee |e verfasserin |4 aut | |
| 700 | 1 | |a Hawken, Steven |e verfasserin |4 aut | |
| 700 | 1 | |a Zhao, Yinshan |e verfasserin |4 aut | |
| 700 | 1 | |a Barbour, Sean J |e verfasserin |4 aut | |
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