tetano
Editor, Senior Moderator
Clin Exp Immunol
. 2023 Apr 19;uxad043.
doi: 10.1093/cei/uxad043. Online ahead of print.
New insights of antineutrophil cytoplasmic antibody-associated vasculitis from the perspective of COVID-19 vaccination
Yang Yang[SUP] 1 [/SUP], Yi Xiong[SUP] 1 [/SUP], Gaosi Xu[SUP] 1 [/SUP]
Affiliations
Abstract
The occurrence of antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) has been reported since the Coronavirus disease 2019 (COVID-19) vaccination, but whether there is a causal relationship or coincidence remains to be verified. We combined the term COVID-19 vaccination with each word of AAV to search for case reports and case series published in PubMed, EMBASE, and Web of Science databases before 13 th March 2023. A total of 56 patients who developed AAV after COVID-19 vaccination were identified from 44 research centers. Of the 56 subjects, 43 (76.7%) were vaccinated with the mRNA vaccine, followed by the adenovirus vaccine (14.3%) and inactivated vaccine (9.0%) (P = 0.015). Compared with relapsed AAV, new-onset AAV patients had at least two other diseases previously (P < 0.001). 25 (44.6%) patients presented symptoms after the first injection, and the medium onset time was 12 (1-77) days, while 28 (50.0%) patients developed symptoms after the second dose, and their medium period was 14 (1-60) days. 44 (78.5%) patients achieved remission after immunosuppressive agents, plasma exchange, and hemodialysis. One (1.8%) patient died from progressive respiratory failure and 9 (16.1%) did not recover, leaving 5 patients permanently dependent on hemodialysis. Pathogenic ANCA may be activated by enhanced immune response and epitope spreading after COVID-19 vaccination and induced the occurrence of AAV, especially in genetically susceptible populations.
Keywords: ANCA; ANCA-associated vasculitis; COVID-19; SARS-CoV-2; autoimmune; vaccination.
. 2023 Apr 19;uxad043.
doi: 10.1093/cei/uxad043. Online ahead of print.
New insights of antineutrophil cytoplasmic antibody-associated vasculitis from the perspective of COVID-19 vaccination
Yang Yang[SUP] 1 [/SUP], Yi Xiong[SUP] 1 [/SUP], Gaosi Xu[SUP] 1 [/SUP]
Affiliations
- PMID: 37074008
- DOI: 10.1093/cei/uxad043
Abstract
The occurrence of antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) has been reported since the Coronavirus disease 2019 (COVID-19) vaccination, but whether there is a causal relationship or coincidence remains to be verified. We combined the term COVID-19 vaccination with each word of AAV to search for case reports and case series published in PubMed, EMBASE, and Web of Science databases before 13 th March 2023. A total of 56 patients who developed AAV after COVID-19 vaccination were identified from 44 research centers. Of the 56 subjects, 43 (76.7%) were vaccinated with the mRNA vaccine, followed by the adenovirus vaccine (14.3%) and inactivated vaccine (9.0%) (P = 0.015). Compared with relapsed AAV, new-onset AAV patients had at least two other diseases previously (P < 0.001). 25 (44.6%) patients presented symptoms after the first injection, and the medium onset time was 12 (1-77) days, while 28 (50.0%) patients developed symptoms after the second dose, and their medium period was 14 (1-60) days. 44 (78.5%) patients achieved remission after immunosuppressive agents, plasma exchange, and hemodialysis. One (1.8%) patient died from progressive respiratory failure and 9 (16.1%) did not recover, leaving 5 patients permanently dependent on hemodialysis. Pathogenic ANCA may be activated by enhanced immune response and epitope spreading after COVID-19 vaccination and induced the occurrence of AAV, especially in genetically susceptible populations.
Keywords: ANCA; ANCA-associated vasculitis; COVID-19; SARS-CoV-2; autoimmune; vaccination.