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mRNA新冠疫苗意外的肾脏副作用:单中心经验及简要综述

Unexpected renal side effects of mRNA COVID-19 vaccines; a single-center experience and short review.

作者信息

Pethő Ákos, Dobi Deján, Kardos Magdolna, Schnabel Karolina

机构信息

Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary.

Institute of Pathology, Forensic and Insurance Medicine, Semmelweis University, Budapest, Hungary.

出版信息

Am J Med Sci. 2025 Jun;369(6):739-744. doi: 10.1016/j.amjms.2025.01.002. Epub 2025 Jan 7.

Abstract

BACKGROUND

In late 2019, the World Health Organization declared Coronavirus disease 2019 a global emergency. Since then, many vaccines have been developed to combat the pandemic. Millions of people have received one of the approved COVID-19 vaccines; unfortunately, some adverse events also have been recorded.

METHODS

In the local health system, patients could get either mRNA vaccines (either Pfizer-BioNTech or Moderna), adenoviral vector vaccine (AstraZeneca), or the vaccine based on inactivated virus (Sinovac). We investigated what immune-mediated adverse events occurred in our department after the COVID-19 vaccination.

RESULTS

We evaluated six patients from our center who received mRNA vaccines and developed suspected immune-mediated adverse events. The immune-mediated adverse events are characterized by de novo or relapsing glomerular diseases and are further confirmed with percutaneous kidney biopsies. During A follow-up of more than two years, remission occurred in five patients, and glomerulonephritis persisted in one of them.

CONCLUSIONS

Vaccinations are pivotal in effectively protecting and preventing various epidemics. As such, it is essential to maintain a high level of vigilance concerning post-vaccination adverse events. This heightened level of suspicion leads to earlier detection, better understanding, and optimal prevention and management of these events. To this end, developing a specific vaccine/patient risk profile is necessary to categorize the target population selectively.

摘要

背景

2019年末,世界卫生组织宣布2019冠状病毒病为全球紧急情况。自那时起,已研发出多种疫苗来对抗这一疫情。数百万人接种了已获批的新冠疫苗之一;不幸的是,也记录到了一些不良事件。

方法

在当地卫生系统中,患者可以接种mRNA疫苗(辉瑞-生物科技或莫德纳)、腺病毒载体疫苗(阿斯利康)或基于灭活病毒的疫苗(科兴)。我们调查了在我们科室接种新冠疫苗后发生的免疫介导不良事件。

结果

我们评估了来自我们中心的6名接种mRNA疫苗并出现疑似免疫介导不良事件的患者。这些免疫介导不良事件的特征为新发或复发的肾小球疾病,并通过经皮肾活检进一步确诊。在两年多的随访期间,5名患者病情缓解,其中1名患者的肾小球肾炎持续存在。

结论

疫苗接种对于有效保护和预防各种流行病至关重要。因此,对于疫苗接种后的不良事件保持高度警惕至关重要。这种更高的怀疑程度能够更早地发现、更好地理解并对这些事件进行最佳的预防和管理。为此,有必要制定特定的疫苗/患者风险概况,以便有选择地对目标人群进行分类。

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