De Novo Glomerular Diseases after COVID-19 Vaccination: Consequence or Coincidence?

Abstract

Introduction: Vaccination against COVID-19 has proven highly effective in preventing severe forms of the disease. However, the literature reports several cases associating renal damage and the anti-COVID vaccine. The aim of our work was to report a case series of patients who developed glomerulopathy after anti-COVID-19 vaccine. We evaluated the type of vaccine, the clinico-biological profile, and the anatomopathological, therapeutic and evolutionary aspects. Material and Methods : Prospective descriptive study conducted at the Nephrology Department of CHU IbnSina in Rabat between December 2021 and June 2022 including 9 patients who presented with glomerulopathy after the 1st dose of anti-COVID-19 vaccine. We excluded patients followed for nephropathy. Results: The mean age of our patients was 33 ± 16 years with a sex ratio of 0.8. Six patients received an inactivated vaccine, 2 patients received a mRNA vaccine and 1 patient received a viral vector vaccine. The mean delay between the onset of signs and the date of the first vaccine dose was 3.1 +/? 0.65 months (1 - 6 months). All patients had a nephrotic syndrome, 2 pure and 7 impure: 3 patients had acute renal failure and microscopic hematuria, 2 patients had microscopic hematuria and 2 patients had acute renal failure. Histologically, focal segmental glomerulosclerosis (FSGS) was noted in 4 patients, lupus nephropathy in 3, and membranous nephropathy (MN) in 2. Specific treatment was administered to each patient, depending on the histological type of renal involvement and the context. After 6 months, complete remission was achieved in 5 patients, with no improvement in 2, and one patient was placed on hemodialysis. One patient died of another cause. Conclusion: The causal link between anti-COVID 19 vaccination and renal disease is highly probable, but remains to be confirmed.