IntroductionSARS-COV-2 infection has caused more than one million deaths in the US and significant economic and life expectancy losses [1]. 10-20% of patients infected with SARS-COV-2 develop persistent or new symptoms after acute infection, known as Post covid syndrome. Endothelial dysfunction secondary to vascular inflammation, autoimmunity, residual infection, and persistent inflammation from dysregulated cytokine signature are thought to play a major pathophysiologic role in the development of the syndrome [2]. COVID-19 is known to cause both ANCA-vasculitis and renal disease (tubular and glomerular disease) early during the course of disease and later after the resolution of early infection [3].ANCA (Anti-neutrophilic cytoplasmic antibody)-associated vasculitis (AAV) is defined as a necrotizing vasculitis with few or no immune deposits and predominantly affecting small vessels and associated with ANCA positivity for myeloperoxidase (MPO-ANCA) or proteinase 3 (PR3-ANCA) [4]. Pauci-immune glomerulonephritis (PIGN) is the most common pattern of injury seen with AAV, and more than 85% of PIGN cases have ANCA positivity [5-6]. Few case reports have shown COVID-19 as a potential trigger for AAV, although its exact role in the occurrence of the vasculitis is not completely understood [7, 8]. Here, we report a unique case of MPO-ANCA positive pauci-immune glomerulonephritis in a relatively healthy female post-COVID-19 infection.