RELAPSE RISK IN PATIENTS WITH MEMBRANOUS NEPHROPATHY AFTER INACTIVATED COVID-19 VACCINATION

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https://storage.unitedwebnetwork.com/files/1099/07521482c513d41ef7f2d71e4ada7448.pdf

Abstract Title

First Name *

Hanzhen

Last Name *

Zhang

Co-author 1

Ruiying Chen 11307120304@fudan.edu.cn Huashan Hospital, Fudan University Division of Nephrology Shanghai

Co-author 2

Mingyue Xu 22211220012@m.fudan.edu.cn Huashan Hospital, Fudan University Division of Nephrology Shanghai

Co-author 3

Xiaoyun Huang x.huang@intelliphecy.com Zhiyu Center for Systems Biology Research and Development Shanghai

Co-author 4

Wenqian Zhao trace4486@163.com Huashan Hospital, Fudan University Division of Nephrology Shanghai

Co-author 5

Jie Zhou zhoujie9108@163.com Huashan Hospital, Fudan University Division of Nephrology Shanghai

Co-author 6

Min Zhang 1185198984@qq.com Huashan Hospital, Fudan University Division of Nephrology Shanghai

Co-author 7

Yunyu Xu eugene215@126.com Huashan Hospital, Fudan University Division of Nephrology Shanghai

Co-author 8

Qionghong Xie qionghongxie@fudan.edu.cn Huashan Hospital, Fudan University Division of Nephrology Shanghai

Co-author 9

Chuan-Ming Hao chuanminghao@fudan.edu.cn Huashan Hospital, Fudan University Division of Nephrology Shanghai

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

While vaccines against coronavirus disease 2019 (COVID-19) have been documented to reduce COVID-19 infection and the rate of severe case after infection, cases of relapse/worsening of membranous nephropathy after vaccination have been reported. The causal relationship between COVID-19 vaccination and membranous nephropathy relapse/worsening has not been established. This study aimed to investigate the relapse/worsening of membranous nephropathy after inactivated COVID-19 vaccination.

Methods

Patients with membranous nephropathy diagnosed before January 1st 2021 and followed up from January 1st 2021 to August 31st 2022 in the Membranous Nephropathy Clinic of Huashan Hospital, Fudan University were included. Clinical data in January 2021 were collected as baseline characteristics, and information about COVID-19 vaccination including the causes of not receiving vaccines was inquired. Among participants with proteinuria <3.5g/d, we assessed association of vaccination with relapse/worsening of membrannous nephropathy. Cardinality matching was used to balance the baseline variables. Relapse/worsening was defined as an increase of proteinuria to >3.5g/d in patients with proteinuria between 0.3g/d and 3.5g/d or to >1 g/d in patients with complete remission (proteinuria <0.3g/d).

Results

A total of 356 patients with membranous nephropathy were enrolled, and 189 (53%) received inactivated COVID-19 vaccines. Among the 167 unvaccinated participants, 118 (71%) worried about a relapse of disease and 47 (28%) had concerns about low efficacy because of immunosuppressive therapy. Among the 235 participants with proteinuria <3.5g/d, 146 were vaccinated and 15 (10%) experienced a relapse/worsening of disease during the follow-up period either before or after vaccination, similar with the unvaccinated 9 (10%). After cardinality matching, there was no difference in the rate of relapse/worsening between these two groups, with 9 (13%) in the unvaccinated group and 10 (14%) in the vaccinated group (Hazard ratio 1.11, 95% confidence interval 0.45-2.72).

Conclusions

Inactivated COVID-19 vaccination was not associated with higher risk of relapse/worsening in patients with membranous nephropathy.

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