New-Onset Acute Interstitial Nephritis Post-SARS-CoV-2 Infection and COVID-19 Vaccination: A Panoramic Review

J Epidemiol Glob Health. 2023 Dec;13(4):615-636. doi: 10.1007/s44197-023-00159-4. Epub 2023 Oct 23.

Abstract

The 2019 coronavirus disease (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) has posed a considerable challenge to global healthcare. Acute interstitial nephritis (AIN) post SARS-CoV-2 infection and vaccination has been reported, but its clinical features and pathogenesis remained unclear. We reviewed so far the largest 22 cases of AIN post SARS-CoV-2 infection and 36 cases of AIN following COVID-19 vaccination. The onset of AIN was mainly related to messenger RNA vaccines (52.8%). Apart from fever, proteinuria (45.5%) was the main manifestation of AIN post SARS-CoV-2 infection, left acute kidney injury (AKI, 63.9%) in patients post COVID-19 vaccination. The potential mechanism of vaccination induced AIN was conjugating vaccines with proteins to form a hapten, which activated dendritic cells and promoted a cascade immunological reaction leading to AIN.

Keywords: Acute interstitial nephritis; COVID-19; SARS-CoV-2; Vaccination.

Publication types

  • Review

MeSH terms

  • COVID-19 Vaccines / adverse effects
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Humans
  • Nephritis, Interstitial* / etiology
  • SARS-CoV-2
  • Vaccination / adverse effects

Substances

  • COVID-19 Vaccines

Supplementary concepts

  • Acute Tubulointerstitial Nephritis