tetano
Editor, Senior Moderator
Cureus
. 2022 Sep 26;14(9):e29613.
doi: 10.7759/cureus.29613. eCollection 2022 Sep.
Nephrotic Syndrome in Adult Patients With COVID-19 Infection or Post COVID-19 Vaccine: A Systematic Review
Ivan Cancarevic[SUP] 1 [/SUP], Mahmoud Nassar[SUP] 1 [/SUP], Luis Medina[SUP] 2 [/SUP], Angelica Sanchez[SUP] 3 [/SUP], Avish Parikh[SUP] 1 [/SUP], Asma Hosna[SUP] 4 [/SUP], Bhavana Devanabanda[SUP] 5 [/SUP], Mallorie Vest[SUP] 1 [/SUP], Fatima Ayotunde[SUP] 1 [/SUP], Muhammad Ghallab[SUP] 1 [/SUP], Ismail Omran[SUP] 1 [/SUP]
Affiliations
Abstract
Nephrotic syndrome is a condition characterized by damage to podocytes that results in significant proteinuria, edema, hyperlipidemia, and hypercoagulability. Infections and malignancies are frequently associated with nephrotic syndrome. The COVID-19 virus has been associated with several atypical presentations of upper respiratory infections and acute kidney injury. Considering that COVID-19 causes systemic inflammatory changes, it seems plausible that it may also lead to nephrotic syndrome. This study aimed to investigate if an association between COVID-19 and the different types of nephrotic syndromes exists. Data were extracted into a spreadsheet. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS, IBM Corp., Armonk, NY, USA). We performed a systematic search of PubMed/Medline and Embase databases using both medical subject headings (MeSH) and regular keywords associated with COVID-19 and nephrotic syndrome, including different types of nephrotic syndromes. The search was performed on 17th December 2021. We included case reports and case series about adult patients who developed findings suggestive of nephrotic syndrome shortly after infection or vaccination. We excluded cases involving children, pregnant women, articles written in languages other than English, and those that were not retrievable. The relevance and quality of identified articles were assessed. We included 32 articles in the study, primarily case reports and case series. In our study, COVID-19 and the COVID-19 vaccine have been associated with the development of nephrotic syndrome, primarily a collapsing form of focal segmental glomerulosclerosis, although other forms have been observed as well. There was little consistency in patient histories, clinical presentations, clinical courses, or treatment regimens, although it appeared that most cases eventually resolved. More cases need to be reported and analyzed before more definitive conclusions can be reached. In conclusion, nephrotic syndrome is a possible complication of both COVID-19 infection and the COVD-19 vaccine and should be considered in patients exhibiting sudden onset edemas or deterioration in kidney function. While the majority of cases respond to standard treatment, clearer guidelines will need to be developed once more data is available.
Keywords: coronavirus disease 2019; coronavirus vaccine; covid 19; focal segmental glomerulosclerosis (fsgs); minimal change; nephrotic syndrome; primary membranous nephropathy.
. 2022 Sep 26;14(9):e29613.
doi: 10.7759/cureus.29613. eCollection 2022 Sep.
Nephrotic Syndrome in Adult Patients With COVID-19 Infection or Post COVID-19 Vaccine: A Systematic Review
Ivan Cancarevic[SUP] 1 [/SUP], Mahmoud Nassar[SUP] 1 [/SUP], Luis Medina[SUP] 2 [/SUP], Angelica Sanchez[SUP] 3 [/SUP], Avish Parikh[SUP] 1 [/SUP], Asma Hosna[SUP] 4 [/SUP], Bhavana Devanabanda[SUP] 5 [/SUP], Mallorie Vest[SUP] 1 [/SUP], Fatima Ayotunde[SUP] 1 [/SUP], Muhammad Ghallab[SUP] 1 [/SUP], Ismail Omran[SUP] 1 [/SUP]
Affiliations
- PMID: 36312654
- PMCID: PMC9595350
- DOI: 10.7759/cureus.29613
Abstract
Nephrotic syndrome is a condition characterized by damage to podocytes that results in significant proteinuria, edema, hyperlipidemia, and hypercoagulability. Infections and malignancies are frequently associated with nephrotic syndrome. The COVID-19 virus has been associated with several atypical presentations of upper respiratory infections and acute kidney injury. Considering that COVID-19 causes systemic inflammatory changes, it seems plausible that it may also lead to nephrotic syndrome. This study aimed to investigate if an association between COVID-19 and the different types of nephrotic syndromes exists. Data were extracted into a spreadsheet. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS, IBM Corp., Armonk, NY, USA). We performed a systematic search of PubMed/Medline and Embase databases using both medical subject headings (MeSH) and regular keywords associated with COVID-19 and nephrotic syndrome, including different types of nephrotic syndromes. The search was performed on 17th December 2021. We included case reports and case series about adult patients who developed findings suggestive of nephrotic syndrome shortly after infection or vaccination. We excluded cases involving children, pregnant women, articles written in languages other than English, and those that were not retrievable. The relevance and quality of identified articles were assessed. We included 32 articles in the study, primarily case reports and case series. In our study, COVID-19 and the COVID-19 vaccine have been associated with the development of nephrotic syndrome, primarily a collapsing form of focal segmental glomerulosclerosis, although other forms have been observed as well. There was little consistency in patient histories, clinical presentations, clinical courses, or treatment regimens, although it appeared that most cases eventually resolved. More cases need to be reported and analyzed before more definitive conclusions can be reached. In conclusion, nephrotic syndrome is a possible complication of both COVID-19 infection and the COVD-19 vaccine and should be considered in patients exhibiting sudden onset edemas or deterioration in kidney function. While the majority of cases respond to standard treatment, clearer guidelines will need to be developed once more data is available.
Keywords: coronavirus disease 2019; coronavirus vaccine; covid 19; focal segmental glomerulosclerosis (fsgs); minimal change; nephrotic syndrome; primary membranous nephropathy.