POS-872 Post covid vaccination- new onset glomerulonephritis- a mere co incidence or a impending reality??

ABSTRACT

Introduction: India is world’s second most populous country with tropical climate and highly dense overcrowded areas which make it an easy target for spread of covid infection. As a preventive measure the government of India launched a vaccination drive from 16th January 2021, currently as of September 2021 more than 806 million doses of the approved vaccine- (covishield- astra Zeneca and covaxin- bharat biotech) have been given. They are both adenovirus carrying viral load and inactivated vaccine respectively. Methods: We will now describe a series of 7 cases of immunogenic glomerulonephritis response following covid vaccination which have been admitted in our tertiary care hospital in southern India between a period of January 2021- September 2021 with signs and symptoms of any of the following nephrotic/ nephritic syndrome, rapidly progressive glomerular disease, isolated proteinurea, hematuria, acute kidney injury and thrombotic complications. All these patients had a similarity in common- all had received single/ 2nd dose of covid vaccine in the last 15 days before the onset of symptoms. All Patients underwent renal biopsy for histological confirmation of the diagnosis as well as covid antibody level testing to see for any relation between the two. once diagnoses was confirmed patients were started on immunosupression in form of steroids, plasmapheresis and other supportive measures like ACE/ ARBs.their outcomes were recorded serially as to whether complete/ partial or no remission was achieved. Results: [Formula presented] All characteristics of the patients including the baseline characteristics- complete blood picture, serum creatinine, electrolytes, 24 hour urine proteinurea. The vaccine type and duration of appearance of symptoms,the renal biopsy findings, the management of each patient and their outcome have been described in the table attached. we had case series of 7 patients with different presentation of glomerulonephritis in the past 9 months with a history of temporal association with covid vaccination in last fortnight. Conclusions: The Immunonephrology Working Group of the ERA-EDTA recently published recommendations on the use of COVID-19 vaccines in patients with autoimmune kidney diseases and supports the vaccination of all individuals without known contraindications. However, these recommendations did not advise on whether vaccination with one vaccine platform was preferable to another. Vigilance should be exercised in patients presenting with new-onset urinary abnormalities and hypertension following COVID-19 vaccination.Besides urinary tract infection and urological causes,glomerulonephritis should be considered in patients with non-resolving macroscopic hematuria. Proteinurea and active sediments in urine. Meanwhile, these isolated reports should not lead to vaccine hesitation during this pandemic as the benefits of vaccination strongly outweigh potential risks. No conflict of interest