MO213: Sars-COV-2 Vaccination DID Not Affect the Clinical Course of IGA Nephropathy in Latvian Adult Cohort

Abstract

BACKGROUND AND AIMSThe current strategy to fight against the COVID-19 pandemic involves active patient vaccination. Patients with renal and autoimmune diseases are in high risk for severe COVID-19 infection [1]. Therefore they should be prioritized for vaccination. Immunoglobulin A nephropathy (IgAN) is one of the most common primary glomerulonephritis triggered by mucous membrane alteration; however, there is a discussion about vaccination-caused IgA flare [2]. The immunological nature of IgAN and misleading information in public sources leaves patients skeptical about whether to get vaccinated [3]. The study aimed to investigate the impact of SARS-CoV-2 vaccination on the clinical course of IgA nephropathy.METHODAdult patients treated in Pauls Stradins Clinical University Hospital with morphologically proven IgAN were included in the study. Patients with secondary IgAN were excluded. Evaluation of clinical and laboratory markers was performed on inclusion visit and on the second visit 6 months later. SARS-CoV-2 vaccination type and status were noted on both visits. Estimated GFR was calculated with CKD-EPI creatinine–cystatin equation. IBM SPSS Statistics version 27 and Microsoft Excel 10 were used for data analysis.RESULTSThe study involved 54 patients, 36 were unvaccinated and 18 were fully vaccinated. A significant difference between the two groups was observed by baseline proteinuria. Other differences were not observed. Fourteen patients were vaccinated with mRNA vaccine, 13 with Comirnaty and 1 with Spikevax, and four patients were vaccinated with Vaxzevria vector vaccine. The differences between the two groups are shown in Table 1. During study period, two patients had COVID-19 infection; a patient in the vaccinated group had COVID-19 prior to vaccination.Table 1.CharacteristicsVaccinatedUnvaccinatedP-value*Total, n1836Male/female, n (%)13/5 (72/28)22/14 (61/39).425Age, years43.4 (9.8)41.6 (11.0).451Baseline eGFR**46.1 (30.7)49.8 (31.6).569Baseline 24-h proteinuria***0.28 (0.32)0.8 (0.97).014Baseline hematuria, n (%)16 (89)28 (78).143Baseline IgA, g/L3.5 (1.2)3 (0.8).147Baseline C3c, g/L1.2 (0.8)1 (0.2).689Delta eGFR**1.8 (5.4)−0.5 (8.5).612Delta 24-h proteinuria***−0.19 (0.33)0.07 (0.65).214Hematuria after 6 months, n (%)13 (72)29 (81).44IgA after 6 months, g/L3.6 (1.1)3.1 (0.8).183C3c after 6 months, g/L1.1 (0.2)1.1 (0.2).517Diseased with COVID-19, n (%)1 (5)1 (3).614Estimates are given as mean values (standard deviation)*Results were analyzed using Mann-Whitney U test and were expressed as P-values.**Estimated GFR, mL/min/1.73 m2.***Estimated 24-h proteinuria, g/24 h/1.73 m2.CONCLUSIONSARS-CoV-2 vaccination did not affect the clinical course of IgA nephropathy. Our study results indicate that SARS-CoV-2 vaccination in IgA nephropathy patients was safe regarding renal function and disease activity markers.