Variant focal segmental collapsing glomerulosclerosis associated with COVID-19 vaccine and highrisk APOL1 genotype clinical case report and bibliographic review

Abstract

Introduction: The COVID-19 pandemic, produced by a mutant strain of coronavirus SARS-CoV-2, which caused worldwide chaos never seen before, started in China in December 2019. In Brazil the first case was confirmed on February 26, 2020 with a 61-year -old patient and the World Health Organization declared a pandemic on March 11, 2020; the aggressiveness of the disease led to an accelerated search for treatments and vaccines, just in July 2021, there were 184 vaccine candidates against COVID-19; Along with immunization, several adverse effects generated by the various vaccines have been reported, ranging from mild to severe, from minor pain at the puncture site to headache, fever, arthralgias, etc. Severe cases have also been reported, such as anaphylaxis, heart disease, renal alterations, etc. which to date are not fully determined. Clinical case: It is related to a clinical case report in Brazil of a 16-year-old female patient, with no significant personal history, who received the first dose of the vaccine for COVID-19 (Pfizer-BioNtech) and 3 days later presented with headache, abdominal pain and arterial hypertension; when assessed and with complementary examinations was determined a rapidly progressive glomerulonephritis, she received treatment with corticosteroids for 3 days; with the biopsy resulted in focal and segmental collapsing glomerulosclerosis with moderate tubulointerstitial repercussion (30-40%). Evolution: The patient developed renal failure and nephritic/nephrotic syndrome. Conclusion: It is not determined with certainty, but there is the possibility of association of glomerular disease with vaccination for COVID-19, it is necessary to continue with the vaccination campaigns and to reduce the aggressiveness of this disease.