New-Onset Complement-Mediated Thrombotic Microangiopathy during the COVID-19 Pandemic

Abstract: Introduction: The coronavirus disease-19 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus is alleged to enable a proinflammatory state that leads to the activation of the coagulation and the complement cascade. In this study, we aimed to establish the impact of the COVID-19 pandemic on patients with new onset of cTMA/aHUS in the Vienna TMA cohort and whether COVID-19 or SARS-CoV-2 vaccinations would pose a greater risk of initial manifestation of cTMA/aHUS. Methods: We used the Vienna TMA cohort database to examine the prevalence of COVID-19-related and of SARS-CoV-2 vaccination-related aHUS/cTMA during the first 3 years of the COVID-19 pandemic in a large single-centre cohort. Results: Between March 2020 and May 2023, a total of 7 patients experienced their first aHUS/cTMA episode. No patient experienced a TMA relapse or more than one episode during the follow-up period. Three TMA episodes were attributable to either COVID-19 (n = 1; 33%) or SARS-CoV-2 vaccination (n = 2; 66%), respectively. All 3 patients had systemic signs of TMA, and TMA was confirmed by kidney biopsy in all cases. Among the 7 patients, we recorded five infections that triggered one TMA episode (20%) and 19 vaccinations triggered two TMA episodes (10%; p = 0.52, odds ratio 0.47; 95% CI: 0.04–8.39). Conclusion: We speculate that both SARS-CoV-2 vaccinations and COVID-19 episodes can represent a triggering factor for aHUS/cTMA episodes in (genetically) vulnerable individuals. However, COVID-19 might have a stronger association and might be a stronger trigger than the SARS-CoV-2 vaccines. The incidence of new aHUS cases did not differ from the pre-pandemic era in a large tertiary care centre cohort.

Object Details

• Location: Deutsche Nationalbibliothek Frankfurt am Main
• Extent: Online-Ressource
• Language: Englisch

References and Relationships

• Bibliographic citation: New-Onset Complement-Mediated Thrombotic Microangiopathy during the COVID-19 Pandemic ; volume:49 ; number:1 ; year:2024 ; pages:978-985 ; extent:8 ; Kidney & blood pressure research ; 49, Heft 1 (2024), 978-985 (gesamt 8)

Contributors, Places and Time

• Creator: Aigner, Christof ; Gaggl, Martina ; Schmidt, Sophie ; Kain, Renate ; Kozakowski, Nicolas ; Oszwald, André ; Prohászka, Zoltán ; Sunder-Plassmann, Raute ; Schmidt, Alice ; Sunder-Plassmann, Gere

Further information

• DOI: 10.1159/000541938
• URN: urn:nbn:de:101:1-2412260151460.396067819233
• Rights: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Last update: 15.08.2025, 7:25 AM CEST