Author’s Reply

We read the article "Outcomes of COVID-19 Vaccine-Associated Glomerular Diseases (CVAGD) -A Case Series from India," 1 attentively and complement the authors on their elegant compilation of CVAGD cases.We, however, have a few comments.The authors identified only one patient with a prior COVID-19 infection.It is unclear if all patients were tested for SARS-CoV-2 using reverse transcriptase-polymerase chain reaction (RT-PCR) since a significant number of infected individuals may remain asymptomatic and acute infection-associated glomerulonephritis, with or without COVID-19 RNA positivity in kidney tissues is well-described.2,3 This is especially relevant to patients described with relapses following COVID-19 vaccination.Viral infections are well-known triggers of relapses in patients with nephrotic syndrome.4 Data on the number of post-infections or infected patients with associated glomerulonephritis would clarify the CVAGD burden.Some studies have reported a reduction in the number of relapses in pediatric patients with nephrotic syndrome during the SARS-CoV-2 pandemic.No such literature is available for adults, and the etiopathogenesis differs from that of the pediatric age group.