In addition, 2 patients with new-onset anti-PLA2R-positive membranous nephropathy were observed in patients with COVID-19, and it is speculated that COVID-19 may reduce the tolerance of PLA2R antigens.[45] It is not clear whether the recurrence of these diseases is related to direct immune activation after vaccination or to chronic immune activation after an asymptomatic allergic reaction. This evidence concerns the gene PLA2R1 and membranous glomerulonephritis.