The impact of COVID-19 pandemic on patients with ANCA associated vasculitis

J Nephrol. 2021 Feb;34(1):185-190. doi: 10.1007/s40620-020-00881-3. Epub 2020 Oct 8.


Introduction: The coronavirus 2019 (COVID-19) pandemic has brought on challenges not only to acute care, but also chronic care of patients. Individuals maintained on immunosuppression appear to be especially susceptible to COVID-19 infection. Patients with ANCA-associated vasculitis (AAV) frequently require immunosuppression and may be at increased risk for developing COVID-19. The incidence and impact of COVID-19 on patients with AAV is currently not known. We aimed to investigate this impact via a telephone questionnaire-based patient survey and chart review.

Methods: A cross-sectional study of AAV patients followed at two centers was conducted. Data regarding demographics, disease characteristics and therapy were confirmed by chart review. A telephone survey was conducted to ascertain symptoms and contact exposure related to COVID-19, as well as changes in health care delivery during the pandemic period between January and July, 2020.

Results: Of the 206 patients surveyed, the median age was 64 years, 51% were female and mean (SD) disease duration was 7 (5) years. The majority had kidney (n = 160) and lung (n = 108) involvement. Seventy-five percent (n = 155) were receiving immunosuppression, with 77 patients (50%) receiving rituximab during the pandemic period. Of the 10 patients tested for severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) by PCR, three were positive. Patients had a significant disruption in care; none had an in-person visit and 69% had a telemedicine consultation. Rituximab maintenance was postponed in 21 patients. Twelve patients experienced disease relapse.

Conclusion: The incidence of COVID-19 in patients with AAV appears to be similar to that of the general population. For a patient population that requires active clinical surveillance, there is significant disruption in care as a result of the pandemic. Reduction of immunosuppression may not be indicated, and the risk of relapse likely far outweighs the risk of COVID-19.

MeSH terms

  • Aged
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / complications
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / therapy*
  • COVID-19 / diagnosis
  • COVID-19 / epidemiology*
  • COVID-19 / therapy
  • Cross-Sectional Studies
  • Cyclophosphamide / therapeutic use
  • Delivery of Health Care / organization & administration*
  • Female
  • Humans
  • Immunologic Factors / therapeutic use
  • Incidence
  • Male
  • Middle Aged
  • Rituximab / therapeutic use
  • Surveys and Questionnaires
  • Telemedicine / organization & administration*


  • Immunologic Factors
  • Rituximab
  • Cyclophosphamide