MULTICENTER STUDY ESTIMATING THE INCIDENCE OF ADVERSE EVENTS FROMSARS-CoV-2 VACCINATION AND ITS POTENTIAL EFFECT ON THE OUTCOME OF LUPUS NEPHRITIS

Abstract Background and Aims The present study aimed to investigate the incidence of adverse events associated with SARS-CoV-2 vaccination in patients with a history of lupus nephritis (LN). Method Patients with biopsy-proven LN, who were vaccinated against SARS-CoV-2, were retrospectively studied. Patients who had reached end-stage kidney disease prior to vaccination were excluded. We recorded the histopathological diagnosis of LN, immunosuppressive regimens which were given for LN, the outcome of LN as a result of treatment, the tome interval form the diagnostic biopsy to vaccination, the number of doses each patient received, all reported adverse effects associated with the vaccine against SARS-CoV-2, including systemic and local adverse events. We also estimated the potential effect of the vaccination on the clinical course of LN among patients who were in remission. Results Ninety patients with systemic lupus erythematosus and renal involvement were included with a mean age of 31 (±18) years, of whom 80% were women. Proliferative LN was present in the diagnostic kidney biopsy in 68 (77.2%) cases and 91.8% of the included patients had achieved remission with treatment prior to vaccination. 86.7% of patients were vaccinated with 3 (2.75, 3) doses. The median time from diagnosis to vaccination was 59 (32-137) months and 70.5% of patients were receiving immunosuppression at the time of vaccination. 30.5% of patients reported systemic adverse reactions and 36.1% local adverse reactions at the site of administration. Among patients in remission who were vaccinated, only 1 (1.2%) patient experienced a relapse of LN within 3 weeks of the 1st dose. Three (3.4%) patients who had treatment-resistant disease experienced a worsening of SLE activity after vaccine administration. Conclusion In this cohort of patients with a history of LN, the SARS-CoV-2 vaccine appears safe, with no effect on the likelihood of disease recurrence among patients who have achieved remission.