The
Coronavirus Disease 2019 (COVID-19) pandemic influenced the management of patients with
anti-neutrophil cytoplasmic antibody (
ANCA)-associated vasculitis. A paucity of data exists on outcome of patients with
vasculitis following
COVID-19, but mortality is higher than in the general population and comparable to patients undergoing haemodialysis or kidney transplant recipients (reported mortality rates of 20-25%). Delays in diagnosis have been reported, which are associated with sequelae such as dialysis-dependency. Management of
ANCA-associated vasculitis has not changed with the aim to suppress disease activity and reduce burden of disease. The use of
rituximab, an important and widely used agent, is associated with a more severe hospital course of
COVID-19 and absence of
antibodies following
severe acute respiratory syndrome (SARS)-CoV-2
infections, which prone patients to
re-infection. Reports on
vaccine antibody response are scarce at the moment, but preliminary findings point towards an impaired immune response, especially when patients receive
rituximab as part of their treatment. Seropositivity was reported in less than 20% of patients when
rituximab was administered within the prior six months, and the antibody response correlated with CD19+ B-cell repopulation. A delay in maintenance doses, if disease activity allows, has been suggested using a CD19+ B-cell guided strategy. Other immunosuppressive measures, which are used in
ANCA-associated vasculitis, also impair humoral and cellular
vaccine responses. Regular measurements of
vaccine response or a healthcare-policy time-based strategy are indicated to provide additional doses ("booster") of
COVID-19 vaccines. This review summarizes a recent educational forum and a recent virtual meeting of the European
Vasculitis Society (EUVAS) focusing on
COVID-19.