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Perspective on COVID-19 vaccination in patients with immune-mediated kidney diseases: consensus statements from the ERA-IWG and EUVAS
KI. Stevens, E. Frangou, JIL. Shin, HJ. Anders, A. Bruchfeld, U. Schönermarck, T. Hauser, K. Westman, GM. Fernandez-Juarez, J. Floege, D. Goumenos, K. Turkmen, C. van Kooten, SP. McAdoo, V. Tesar, M. Segelmark, D. Geetha, DRW. Jayne, A....
Language English Country England, Great Britain
Document type Journal Article
NLK
Free Medical Journals
from 1996 to 1 year ago
Open Access Digital Library
from 1996-01-01
PubMed
35244174
DOI
10.1093/ndt/gfac052
Knihovny.cz E-resources
- MeSH
- COVID-19 prevention & control MeSH
- Mycophenolic Acid therapeutic use MeSH
- Humans MeSH
- Kidney Diseases * drug therapy immunology MeSH
- Antibodies, Viral MeSH
- Rituximab therapeutic use MeSH
- COVID-19 Vaccines * adverse effects immunology MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
Patients with immune-mediated kidney diseases are at increased risk of severe coronavirus disease 2019 (COVID-19). The international rollout of COVID-19 vaccines has provided varying degrees of protection and enabled the understanding of vaccine efficacy and safety. The immune response to COVID-19 vaccines is lower in most patients with immune-mediated kidney diseases; either related to immunosuppression or comorbidities and complications caused by the underlying disease. Humoral vaccine response, measured by the presence of antibodies, is impaired or absent in patients receiving rituximab, mycophenolate mofetil (MMF), higher doses of glucocorticoids and likely other immunosuppressants, such as cyclophosphamide. The timing between the use of these agents and administration of vaccines is associated with the level of immune response: with rituximab, vaccine response can only be expected once B cells start to recover and patients with transient discontinuation of MMF mount a humoral response more frequently. The emergence of new COVID-19 variants and waning of vaccine-induced immunity highlight the value of a booster dose and the need to develop mutant-proof vaccines. COVID-19 vaccines are safe, exhibiting a very low risk of de novo or relapsing immune-mediated kidney disease. Population-based studies will determine whether this is causal or coincidental. Such cases respond to standard management, including the use of immunosuppression. The Immunonephrology Working Group and European Vasculitis Society recommend that patients with immune-mediated kidney diseases follow national guidance on vaccination. Booster doses based on antibody measurements could be considered.
Department of Health Medicine and Caring Sciences Linköping University Linköping Sweden
Department of Medicine University of Cambridge Cambridge UK
Department of Nephrology and Renal Transplantation Patras University Hospital Patras Greece
Department of Nephrology Hospital Universitatio Fundacion Alcorcon Alcorcon Spain
Department of Nephrology Limassol General Hospital Limassol Cyprus
Department of Pediatrics Yonsei University College of Medicine Seoul South Korea
Division of Nephrology Department of Internal Medicine Necmettin Erbakan University Konya Turkey
Division of Nephrology RWTH Aachen University Hospital Aachen Germany
Glasgow Renal and Transplant Unit Queen Elizabeth University Hospital Glasgow UK
References provided by Crossref.org
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