背景:在COVID-19感染和接种疫苗后,肾小球疾病(GD)的报道越来越多。目前关于COVID-19感染或疫苗接种与GD之间可能存在联系的证据是相互矛盾的。
目的:本研究对研究进行了范围审查,以描述COVID-19感染与GD疫苗接种之间的关系以及该疾病的常见管理策略和总体结局,以确定知识差距并指导进一步的研究。
方法:在2022年9月5日之前以英文发表的所有原始研究都被考虑纳入审查。排除标准是动物研究,尸检研究,以及涉及儿科患者(<16岁)的数据,是移植接受者,肾小球疾病复发,患有可能导致肾小球疾病的癌症或非COVID-19感染,或者没有接受肾活检。
方法:搜索的五个电子数据库是MEDLINE,PubMed,Scopus,EMBASE,还有Cochrane.
方法:使用布尔运算符“AND”将与COVID-19和肾小球疾病相关的两个单独的搜索字符串组合在一起。过滤器用于将出版物限制为以英语发表的原始研究。将来自每个数据库的搜索结果导入到Covidence软件中(www。covidence.org)并用于重复数据删除,文章筛选,和数据提取。描述性分析被用来总结人口统计,诊断,和治疗结果。
结果:删除重复项之后,筛选了6853个标题和摘要。在188项研究中,106项研究描述了341例COVID-19感染后的GD患者,82例描述了146例COVID-19疫苗接种后的GD患者。IgA肾病是COVID-19疫苗接种后报告的最常见的GD病理学,在mRNA疫苗后最常见。COVID-19感染后最常见的是塌陷性局灶节段肾小球硬化。GD的免疫抑制治疗在疫苗队列中比在感染队列中更常见。
结论:尽管世界各地有大量的COVID-19感染和疫苗接种,我们对与COVID-19感染和疫苗接种相关的GD的理解仍然很差,需要更多的研究来更好地理解可能的关系。
BACKGROUND: There are increasing reports of glomerular disease (GD) following COVID-19 infection and vaccination. Current evidence on the possible link between COVID-19 infection or vaccination and GD is conflicting.
OBJECTIVE: The present study undertakes a scoping review of research to describe the relationship between COVID-19 infection and vaccination with GD and the common management strategies and overall outcomes of the disease to identify knowledge gaps and guide further research.
METHODS: All original research studies published in English until 5th September 2022 were considered for inclusion in the review. Exclusion criteria were animal studies, autopsy studies, and data involving patients who were paediatric patients (< 16 years), were transplant recipients, had a recurrence of glomerular disease, had concomitant cancer or non-COVID-19 infection which may cause glomerular disease, or did not receive a renal biopsy.
METHODS: The five electronic databases searched were MEDLINE, PubMed, Scopus, EMBASE, and Cochrane.
METHODS: Two separate search strings related to COVID-19, and glomerular disease were combined using the Boolean operator \'AND\'. Filters were used to limit publications to original research studies published in English. Search results from each database were imported into Covidence software ( www.covidence.org ) and used for de-duplication, article screening, and data extraction. Descriptive analyses were used to summarise demographics, diagnoses, and treatment outcomes.
RESULTS: After removing duplicates, 6853 titles and abstracts were screened. Of the 188 studies included, 106 studies described 341 patients with GD following COVID-19 infection and 82 described 146 patients with GD following a COVID-19 vaccination. IgA nephropathy was the most common GD pathology reported following COVID-19 vaccination with GD most common following mRNA vaccines. Collapsing focal segmental glomerulosclerosis was the most common GD following COVID-19 infection. Immunosuppressive treatment of GD was more common in the vaccine cohort than in the infection cohort.
CONCLUSIONS: Despite the significant number of COVID-19 infections and vaccinations around the world, our understanding of GD associated with COVID-19 infection and vaccination remains poor, and more research is needed to understand the possible relationship better.