mRNA - COVID-19疫苗的意外肾副作用单中心体验和简短回顾。

Ákos Pethő, Deján Dobi, Magdolna Kardos, Karolina Schnabel
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摘要

背景:2019年底,世界卫生组织宣布2019年冠状病毒病为全球紧急情况。从那时起,研制了许多疫苗来对抗大流行。数百万人接种了一种获批的COVID-19疫苗;不幸的是,也记录了一些不良事件。方法:在当地卫生系统中,患者可接种mRNA疫苗(辉瑞- biontech或Moderna)、腺病毒载体疫苗(阿斯利康)或基于灭活病毒的疫苗(科华)。我们调查了我科在COVID-19疫苗接种后发生的免疫介导的不良事件。结果:我们评估了本中心6例接种mRNA疫苗并出现疑似免疫介导不良事件的患者。免疫介导的不良事件以新生或复发的肾小球疾病为特征,经皮肾活检进一步证实。在两年多的随访中,5名患者出现缓解,其中1名患者肾小球肾炎持续存在。结论:疫苗接种是有效保护和预防各种流行病的关键。因此,必须对疫苗接种后的不良事件保持高度警惕。这种高度的怀疑导致更早地发现、更好地理解和最佳地预防和管理这些事件。为此,有必要制定具体的疫苗/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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Unexpected renal side effects of mRNA COVID-19 vaccines; a single-center experience and short review.

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.

Conclusion: 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.

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