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. 2020 May 22;13(3):347-353.
doi: 10.1093/ckj/sfaa088. eCollection 2020 Jun.

Indirect effects of severe acute respiratory syndrome coronavirus 2 on the kidney in coronavirus disease patients

Aymeric Couturier  1   2 , Sophie Ferlicot  3 , Kévin Chevalier  4 , Matthieu Guillet  5   6 , Marie Essig  1   2   6 , Stéphane Jauréguiberry  2   4 , Rocco Collarino  4 , Mathilde Dargelos  1 , Alice Michaut  3 , Guillaume Geri  2   6   7 , Anne-Marie Roque-Afonso  6   8 , Mohamad Zaidan  5   6 , Ziad A Massy  1   2   6
Affiliations

Indirect effects of severe acute respiratory syndrome coronavirus 2 on the kidney in coronavirus disease patients

Aymeric Couturier et al. Clin Kidney J. .

Abstract

Among patients hospitalized for novel coronavirus disease (COVID-19), between 10 and 14% develop an acute kidney injury and around half display marked proteinuria and haematuria. Post-mortem analyses of COVID-19 kidney tissue suggest that renal tubular cells and podocytes are affected. Here we report two cases of collapsing glomerulopathy and tubulointerstitial lesions in living COVID-19 patients. Despite our use of sensitive reverse transcription polymerase chain reaction techniques in this study, we failed to detect the virus in blood, urine and kidney tissues. Our observations suggest that these kidney lesions are probably not due to direct infection of the kidney by severe acute respiratory syndrome coronavirus 2.

Keywords: APOL1; COVID-19; SARS-CoV-2; collapsing glomerulopathy; kidney disease.

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Figures

FIGURE 1
FIGURE 1
Schematic descriptions of (A) Patient 1 and (B) Patient 2.
FIGURE 2
FIGURE 2
(A) Patient 1 (trichrome stain, ×400): a glomerulus with global collapse of the capillaries, associated with marked hyperplasia and swelling of overlying podocytes that contain cytoplasmic large vacuoles. (B) Patient 1 (PAS stain, ×400): swollen podocytes showing numerous PAS-positive cytoplasmic droplets. (C) Patient 2 (Jones methenamine silver stain, ×400): pronounced collapsing features, with vacuolated podocytes and capillary obliteration. (D) Patient 2 (trichrome stain, ×200): a glomerulus with a FSGS collapsing variant, together with acute tubular injury and a few tubules with cytoplasmic protein droplets (arrow).
FIGURE 3
FIGURE 3
Patient 1: immunohistochemistry of infiltrating mononuclear cells. Inflammation consisted of B lymphocytes labelled with anti-CD20 antibody (A, magnification ×200), T lymphocytes labelled with anti-CD3 antibody (B, magnification ×200) and numerous macrophages within the interstitium, more rarely in the glomerulus (C, magnification ×200) and in the lumen of tubules (D, magnification ×100) labelled with anti-CD68 antibody.
See this image and copyright information in PMC

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