Yeaman M.R: Immunosuppression in Glomerular Diseases: Implications for SARS-CoV-2 Vaccines and COVID-19. Glomerular Diseases DOI 10.1159/000519182
Patients with chronic glomerulonephritis (GN) often have underlying immunological abnormalities that can be further altered by concomitant immunosuppressive (IS) therapy. In the era of the COVID-19 pandemic these changes can impact the ability of COVID vaccines to impart protective immunity, influence susceptibility to SARS-CoV-2 infection, and influence the natural clinical evolution of COVID-19.
In a very scholarly, comprehensive, and well-written review, Dr. Yeaman has summarized these issues in a very useful and understandable fashion. It is difficult to do justice to this elegant presentation in only a few short words. Physicians caring for patients with GN who are also receiving IS agents and who are concerned about COVID-19 infections or COVID vaccine administration should read this review in the original form. The effects of uremia itself, steroids, alkylating agents, anti-metabolites, calcineurin inhibitors, mTOR inhibitors, and CD38 monoclonal antibodies are discussed. Strategies to optimize the safety and effectiveness of COVID-19-preventative measures in patients with GN receiving IS treatment are also stressed. Altogether, a timely and highly relevant contemporary review of a subject of immense global importance.