Petrou Dimitra, Marinaki Smaragdi, Kriki Pelagia, Flouda Sofia, Venetsanopoulou Aliki, Voulgari Paraskevi, Sardeli Aggeliki, Drouzas Konstantinos, Panagoutsos Stylianos, Liapis George, Gakiopoulou Harikleia, Lionaki Sophia
Division of Nephrology, 2nd Department of Internal Medicine, Attikon University Hospital, School of Health Sciences, National and Kapodistrian University of Athens, 12462 Athens, Greece.
Department of Nephrology and Renal Transplantation, Laiko Hospital Athens, School of Health Sciences, National and Kapodistrian University of Athens, 11527 Athens, Greece.
J Clin Med. 2025 Jan 10;14(2):406. doi: 10.3390/jcm14020406.
Vaccination against SARS-CoV-2 has been vital in alleviating the spread of the recent pandemic. We aimed to estimate the frequency and type of adverse events related to SARS-CoV-2 vaccine in patients with lupus nephritis (LN), and assess its impact, if any, on the risk of subsequent reactivation of nephritis. This was a retrospective, multicenter study which included patients with biopsy-proven LN, who had received at least one vaccine dose. Patients who ended up with end-stage kidney disease (ESKD) prior to vaccination or were diagnosed with LN after vaccination were excluded. Adverse events, systemic or local, COVID-19 outcomes (full recovery, death, or long COVID-19), outcome of LN (remission, refractory disease, relapse, ESKD or death), demographics, laboratory measurements, and immunosuppressive regimens were recorded. Sixty-seven patients were included. The median age was 33 (20-46) years. Induction therapy for LN was administered to 92.5% of patients and 74.6% received maintenance therapy. Of these, 94.02% were in remission at vaccination. The BNT162b2 mRNA vaccine was administered in 97.01% of cases, with mild systemic adverse symptoms in 28.35% (myalgias 17.91%, headache 13.43%, arthralgias 13.43%, and fever 10.44%) and local adverse effects in 35.82% (pain 25.37%, swelling 13.43%). Overall, among patients in remission upon vaccination, two (3.17%) experienced a LN relapse within 5.75 (±0.25) months, while 75% of those with active disease at vaccination achieved remission within 21 (±2) months. SARS-CoV-2 vaccination appears safe for LN patients without serious adverse events occurring, and there is no significant impact in the clinical course of the disease.
接种新型冠状病毒2（SARS-CoV-2）疫苗对于缓解近期大流行的传播至关重要。我们旨在估计狼疮性肾炎（LN）患者中与SARS-CoV-2疫苗相关的不良事件的频率和类型，并评估其对随后肾炎再激活风险的影响（如有）。这是一项回顾性多中心研究，纳入了经活检证实为LN且至少接种过一剂疫苗的患者。排除在接种疫苗前最终发展为终末期肾病（ESKD）或在接种疫苗后被诊断为LN的患者。记录不良事件（全身性或局部性）、COVID-19结局（完全康复、死亡或长期COVID-19）、LN结局（缓解、难治性疾病、复发、ESKD或死亡）、人口统计学、实验室测量结果和免疫抑制方案。纳入了67例患者。中位年龄为33（20-46）岁。92.5%的患者接受了LN诱导治疗，74.6%的患者接受了维持治疗。其中，94.02%的患者在接种疫苗时处于缓解期。97.01%的病例接种了BNT162b2 mRNA疫苗，28.35%出现轻度全身性不良症状（肌痛17.91%、头痛13.43%、关节痛13.43%、发热10.44%），35.82%出现局部不良反应（疼痛25.37%、肿胀13.43%）。总体而言，在接种疫苗时处于缓解期的患者中，有2例（3.17%）在5.75（±0.25）个月内出现LN复发，而接种疫苗时患有活动性疾病的患者中有75%在21（±2）个月内实现缓解。SARS-CoV-2疫苗接种对LN患者似乎是安全的，未发生严重不良事件，且对疾病临床进程无显著影响。
