# Outcome of Glomerular Disease Manifesting After Vaccination Against Severe Acute Respiratory Syndrome Coronavirus 2

## TL;DR

This study reports cases of kidney disease that occurred after receiving a SARS-CoV-2 vaccine, suggesting a possible immune-related link.

## Contribution

The study identifies and categorizes various types of glomerular disease following SARS-CoV-2 vaccination, noting their timing and potential triggers.

## Key findings

- Eight out of ten cases of glomerular disease occurred after a second or booster dose of the vaccine.
- Glomerular disease onset typically occurred within a week of vaccination.
- Two cases revealed pre-existing kidney conditions unmasked by vaccination.

## Abstract

Introduction

Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can upregulate the immune system and may contribute to glomerular disease (GD). Here, we describe a spectrum of GD that manifested following vaccination against SARS-CoV-2 (COVID-19 vaccinations).

Material and methods

This was a descriptive study of 10 cases enrolled between January 2021 and January 2023. Patients with biopsy-proven GD that manifested following COVID-19 vaccinations were included.

Results

We found 10 cases of biopsy-proven GD following the COVID-19 vaccination. This included five cases of minimal change disease (MCD), three cases of focal segmental glomerulosclerosis (FSGS), one case of C3 glomerulonephritis (C3GN), and one case of IgA nephropathy (IgAN). The pre-existing disease was found in the last two patients (IgAN and C3GN) who got unmasked following vaccination. We did not observe any relation between vaccine type (Covisheld; six cases vs. Covaxin; four cases) and GD. In most cases (8/10 cases, 80.0%), GD developed after a repeat dose (second or booster dose). The onset time following vaccination was typically less than a week, and even less following a repeat dose.

Conclusion

Post-vaccination GD can be either de novo or a flare-up of a pre-existing one. The onset time following vaccination was typically less than a week for both Covishield and Covaxin.