Nephrologists from Nanchang University Investigate Kidney Injury Linked to COVID-19 Vaccines—Rare but Real

Nephrologists affiliated with the Second Affiliated Hospital of Nanchang University conducted a relevant literature on Acute Interstitial Nephritis (AIN) post SARS-CoV-2 infection or vaccination through electronic databases, including PubMed, EMBASE, and Web of Science, using several relevant keywords. With output focused on medians and ranges for continuous data and numbers and percentages for categorical data, the team based in Nanjing, a city of nearly 10 million located in Jiangsu Province employed use of descriptive statistics, with ensuing statistical analysis. For example, Gaosi Xu, M.D., Ph.D., and corresponding author and colleagues used the Mann–Whitney Test for continuous data, as well as a Chi-Square Test for categorical data in a bid to establish if two study groups were statistically different. The team employed use of Fisher's Exact Test for both simple four-table and R × C table data, given the team’s sample size was less than 40. All statistical analyses were performed via SPSS 25.0 software, establishing a P value < 0.05 as a measure of statistical significance. The authors reported a review of the largest 22 cases of AIN post COVID-19 infection, as well as 36 cases of AIN post COVID-19 vaccination. Importantly, a majority of COVID-19 vaccine-related AIN associated with mRNA vaccines (52.8%). Along with fever, excess protein in the urine (proteinuria) was the majority symptom at 45.5% linked to COVID-19 infection-related AIN. Left acute kidney injury or “AKI” represented 63.9% of COVID-19 vaccine injuries. The proposed mechanism of action involving AIN vaccine-related injury: conjugating vaccines with proteins form hapten, thereby activating dendritic cells promoting a cascade of immunological reactions leading to AIN.

Published in the peer-reviewed Journal of Epidemiology and Global Health, the Chinese nephrologists emphasize that the vast majority of adverse events linked to the COVID-19 vaccines were “nonserious, such as fatigue, headache, and myalgia.”