Leila Mahmoudnia
1 
, Bijan Roshan
2 , Hamid Reza Jahantigh
3,4 , Zahra Mojtahedi
5, Oscar F Borja Montes
6, Tella Sadighpour
7 , Mohammadreza Khosravifarsani
8* 1 Department of Nephrology, Shahrekord University of Medical Sciences, Shahrekord, Iran
2 Division of Nephrology, Scripps Clinic, La Jolla, California, USA
3 Interdisciplinary Department of Medicine-Section of Occupational Medicine, University of Bari, 70124 Bari, Italy
4 Animal Health and Zoonosis, PhD Course, Department of Veterinary Medicine, University of Bari, Bari, Italy
5 Department of Health Care Administration and Policy, School of Public Health, University of Nevada, Las Vegas, NV 89154, USA
6 Department of Internal Medicine, University of New Mexico, New Mexico, USA
7 American University of Antigua College of Medicine, Antigua and Barbuda
8 Department of Internal Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
Abstract
From March 2020, the coronavirus disease 2019 (COVID-19) pandemic challenged public health and healthcare systems worldwide. Viral infection is one of the environmental factors that has been associated with the development, relapse, or exacerbation of systemic lupus erythematosus (SLE). SLE patients are at an increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) because of immune system dysfunction related to their disease as well as immunosuppression medications. So far, the most effective way to reduce SARS-CoV-2 infection-induced hospitalization and death is vaccination. On the other hand, SLE patients present distinct challenges related to the safety and effectiveness of SARS-CoV-2 vaccination. We have reviewed some reports on the onset or flare of SLE post-COVID-19 vaccination. Of note, the mRNA COVID-19 vaccines are associated with increased SLE disease activity, more frequently than the other types of COVID-19 vaccines.
Implication for health policy/practice/research/medical education:
There is no clear mechanism for describing systemic lupus erythematosus (SLE) development or flare after COVID-19 vaccinations, however, numerous hypotheses might elucidate this association. The increased concentration of type I interferon especially after the mRNA COVID-19 vaccination may explain the higher rate of SLE and SLE flares following vaccination.
Please cite this paper as: Mahmoudnia L, Roshan B, Jahantigh HR, Mojtahedi Z, F Borja Montes O, Sadighpour T, Khosravifarsani M. Systemic lupus erythematosus following SARS-CoV-2 vaccination; a review of literature. J Nephropharmacol. 2023;12(1):e10564. DOI: 10.34172/npj.2022.10564.