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Abstract: TH-PO474

COVID-19 Infection and Vaccination in Patients With Glomerular Disease: An Analysis of the Cure Glomerulonephropathy (CureGN) Study

Session Information

Category: Glomerular Diseases

  • 1303 Glomerular Diseases: Clinical‚ Outcomes‚ and Trials

Authors

  • Glenn, Dorey A., University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States
  • Wang, Chia- Shi, Emory University, Atlanta, Georgia, United States
  • Helmuth, Margaret, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Coppock, Gaia M., University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Khalid, Myda, Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana, United States
  • Smith, Abigail R., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Tuttle, Katherine R., Providence Health and Services, Renton, Washington, United States
  • Robinson, Bruce M., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Bou Matar, Raed, Cleveland Clinic Children's Hospital, Cleveland, Ohio, United States
  • Gipson, Debbie, University of Michigan, Ann Arbor, Michigan, United States
  • Bomback, Andrew S., Columbia University, New York, New York, United States
  • Mariani, Laura H., University of Michigan, Ann Arbor, Michigan, United States

Group or Team Name

  • on behalf of the CureGN consoritum
Background

Persons with glomerular diseases (GD) are vulnerable to severe COVID19 infection, yet may be hesitant to receive vaccines. We sought to understand predictors for severe COVID19 infection in GD and the effectiveness and safety of COVID19 vaccines.

Methods

CureGN is a prospective observational study of patients with minimal change disease, focal segmental glomerulosclerosis, membranous nephropathy, or IgA Nephropathy. Beginning in July 2021, a questioanire was administered at study visits to assess evidence of COVID19 infection, vaccination, and clinical features of COVID19-related hospitalizations. Severe infection was defined as COVID19-associated hospitalization or death. Predictors of severe infection were evaluated using multivariable logistic regression models, adjusting for age, vaccination status, and comorbidities (base model), then individually adjusting for immunosuppression, race, ethnicity, GD subtype, eGFR, and UPCR. eGFR slope pre- and post- infection or COVID19 vaccination were estimated using interrupted time series analyses.

Results

From July 2021 to March 2022, 1182 participants were surveyed with 177 (15%) reporting COVID19 infection. Of those, 39 (22%) developed severe illness, including 2 deaths. Over study follow-up, the proportion of vaccine-eligble participants who had received ≥1 COVID19 vaccine increased from 55% to 70%. Lower eGFR pre-infection was associated with a higher odds of severe infection (OR[95%CI]: 1.19 [1.04,1.37] per 10 unit decrease in eGFR (base model). COVID19 infection was associated with a 5.04 (SD 2.31) unit drop in eGFR at the time of infection. No change in eGFR was seen following vaccination (Figures 1a and b). Crude vaccine effectiveness was 80% for “any” and 86% for “severe” infection.

Conclusion

COVID19 infection resulted in high rates of hospitalization and acute decline in eGFR among GD patients. Vaccination was associated with lower rates of COVID19 infection and severe disease and did not affect kidney function in the short term.

Figure 1: eGFR slope pre- and post-COVID19 Infection (a) and vaccination (b).

Funding

  • NIDDK Support