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The COVID-19 pandemic and ANCA-associated vasculitis - reports from the EUVAS meeting and EUVAS education forum.
Kronbichler, Andreas; Geetha, Duvuru; Smith, Rona M; Egan, Allyson C; Bajema, Ingeborg M; Schönermarck, Ulf; Mahr, Alfred; Anders, Hans-Joachim; Bruchfeld, Annette; Cid, Maria C; Jayne, David R W.
  • Kronbichler A; Department of Medicine, University of Cambridge, CB2 0QQ Cambridge, United Kingdom. Electronic address: ak2283@cam.ac.uk.
  • Geetha D; Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  • Smith RM; Department of Medicine, University of Cambridge, CB2 0QQ Cambridge, United Kingdom.
  • Egan AC; Department of Medicine, University of Cambridge, CB2 0QQ Cambridge, United Kingdom.
  • Bajema IM; Department of Pathology, L1Q, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, the Netherlands.
  • Schönermarck U; Division of Nephrology, Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany.
  • Mahr A; Department of Rheumatology, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland.
  • Anders HJ; Division of Nephrology, Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany.
  • Bruchfeld A; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Department of Renal Medicine, Karolinska University Hospital and CLINTEC Karolinska Institutet, Stockholm, Sweden.
  • Cid MC; Department of Autoimmune Diseases, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
  • Jayne DRW; Department of Medicine, University of Cambridge, CB2 0QQ Cambridge, United Kingdom.
Autoimmun Rev ; 20(12): 102986, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1491723
ABSTRACT
The Coronavirus Disease 2019 (COVID-19) pandemic influenced the management of patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis. A paucity of data exists on outcome of patients with vasculitis following COVID-19, but mortality is higher than in the general population and comparable to patients undergoing haemodialysis or kidney transplant recipients (reported mortality rates of 20-25%). Delays in diagnosis have been reported, which are associated with sequelae such as dialysis-dependency. Management of ANCA-associated vasculitis has not changed with the aim to suppress disease activity and reduce burden of disease. The use of rituximab, an important and widely used agent, is associated with a more severe hospital course of COVID-19 and absence of antibodies following severe acute respiratory syndrome (SARS)-CoV-2 infections, which prone patients to re-infection. Reports on vaccine antibody response are scarce at the moment, but preliminary findings point towards an impaired immune response, especially when patients receive rituximab as part of their treatment. Seropositivity was reported in less than 20% of patients when rituximab was administered within the prior six months, and the antibody response correlated with CD19+ B-cell repopulation. A delay in maintenance doses, if disease activity allows, has been suggested using a CD19+ B-cell guided strategy. Other immunosuppressive measures, which are used in ANCA-associated vasculitis, also impair humoral and cellular vaccine responses. Regular measurements of vaccine response or a healthcare-policy time-based strategy are indicated to provide additional doses ("booster") of COVID-19 vaccines. This review summarizes a recent educational forum and a recent virtual meeting of the European Vasculitis Society (EUVAS) focusing on COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid / Vaccines Limits: Humans Language: English Journal: Autoimmun Rev Journal subject: Allergy and Immunology Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid / Vaccines Limits: Humans Language: English Journal: Autoimmun Rev Journal subject: Allergy and Immunology Year: 2021 Document Type: Article