RESUMEN
We present the case of a male patient with severe SARS-CoV-2 pneumonia, with simultaneous onset of p-ANCA positive rapidly progressive glomerulonephritis. We discuss the different therapeutic possibilities, emphasising the appropriateness of their administration according to the time in the course of the infection.
Asunto(s)
COVID-19 , Glomerulonefritis , Nefritis , Anticuerpos Anticitoplasma de Neutrófilos , COVID-19/complicaciones , Glomerulonefritis/tratamiento farmacológico , Glomerulonefritis/terapia , Humanos , Masculino , SARS-CoV-2RESUMEN
Presentamos el caso de un varón afecto por neumonía SARS-CoV-2 grave, que a la vez comienza con una glomerulonefritis rápidamente progresiva p-ANCA positiva. Se comentan las distintas posibilidades terapéuticas haciendo hincapié en la idoneidad de su administración según el momento evolutivo de la infección. (AU)
We present the case of a male patient with severe SARS-CoV-2 pneumonia, with simultaneous onset of p-ANCA positive rapidly progressive glomerulonephritis. We discuss the different therapeutic possibilities, emphasising the appropriateness of their administration according to the time in the course of the infection. (AU)
Asunto(s)
Humanos , Masculino , Nefrología , Infecciones por Coronavirus/epidemiología , Enfermedad por Anticuerpos Antimembrana Basal Glomerular/terapia , Neumonía/terapia , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/terapia , AortitisRESUMEN
BACKGROUND: Chronic kidney disease (CKD) patients are at high-risk for severe coronavirus disease 2019 (COVID-19). The multicentric, observational and prospective SENCOVAC study aims to describe the humoral response and safety of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines in CKD patients. Safety and immediate humoral response results are reported here. METHODS: Four cohorts of patients were included: kidney transplant (KT) recipients, and haemodialysis (HD), peritoneal dialysis (PD) and non-dialysis CKD patients from 50 Spanish centres. Adverse events after vaccine doses were recorded. At baseline and on Day 28 after the last vaccine dose, anti-Spike antibodies were measured and compared between cohorts. Factors associated with development of anti-Spike antibodies were analysed. RESULTS: A total of 1746 participants were recruited: 1116 HD, 171 PD, 176 non-dialysis CKD patients and 283 KT recipients. Most patients (98%) received mRNA vaccines. At least one vaccine reaction developed after the first dose in 763 (53.5%) and after the second dose in 741 (54.5%) of patients. Anti-Spike antibodies were measured in the first 301 patients. At 28 days, 95% of patients had developed antibodies: 79% of KT, 98% of HD, 99% of PD and 100% of non-dialysis CKD patients (P < 0.001). In a multivariate adjusted analysis, absence of an antibody response was independently associated with KT (odds ratio 20.56, P = 0.001) and with BNT162b2 vaccine (odds ratio 6.03, P = 0.023). CONCLUSION: The rate of anti-Spike antibody development after vaccination in KT patients was low but in other CKD patients it approached 100%, suggesting that KT patients require persistent isolation measures and booster doses of a COVID-19 vaccine. Potential differences between COVID-19 vaccines should be explored in prospective controlled studies.
Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , Insuficiencia Renal Crónica , Anticuerpos Antivirales , Vacuna BNT162 , COVID-19/prevención & control , Vacunas contra la COVID-19/efectos adversos , Humanos , Estudios Prospectivos , Insuficiencia Renal Crónica/complicaciones , Insuficiencia Renal Crónica/terapia , SARS-CoV-2RESUMEN
We present the case of a male patient with severe SARS-CoV-2 pneumonia, with simultaneous onset of p-ANCA positive rapidly progressive glomerulonephritis. We discuss the different therapeutic possibilities, emphasising the appropriateness of their administration according to the time in the course of the infection.
RESUMEN
No disponible
Asunto(s)
Humanos , Infecciones Oportunistas Relacionadas con el SIDA/diagnóstico , Glomerulonefritis/diagnóstico , Hepatitis C/complicaciones , Leishmaniasis Visceral/diagnóstico , NecrosisRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Adulto , Plasmaféresis/efectos adversos , Trombosis/complicaciones , Glomeruloesclerosis Focal y Segmentaria/terapia , Edema/etiologíaAsunto(s)
Plasmaféresis/efectos adversos , Trombosis de la Vena/etiología , Adulto , Humanos , MasculinoRESUMEN
No disponible
