COVID-19-Associated Kidney Injury: A Case Series of Kidney Biopsy Findings
| Autor: | Purva, Sharma, Nupur N, Uppal, Rimda, Wanchoo, Hitesh H, Shah, Yihe, Yang, Rushang, Parikh, Yuriy, Khanin, Varun, Madireddy, Christopher P, Larsen, Kenar D, Jhaveri, Vanesa, Bijol |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Thrombotic microangiopathy Biopsy Pneumonia Viral 030232 urology & nephrology 030204 cardiovascular system & hematology urologic and male genital diseases Kidney Gastroenterology 03 medical and health sciences Betacoronavirus 0302 clinical medicine Internal medicine medicine Humans Microscopic hematuria Pandemics Acute tubular necrosis Aged Proteinuria medicine.diagnostic_test business.industry urogenital system SARS-CoV-2 Acute kidney injury COVID-19 General Medicine Acute Kidney Injury Kidney Tubular Necrosis Acute Middle Aged medicine.disease female genital diseases and pregnancy complications medicine.anatomical_structure Nephrology Female medicine.symptom Complication business Coronavirus Infections Rapid Communication |
| Zdroj: | J Am Soc Nephrol |
| ISSN: | 1533-3450 |
| Popis: | Background Reports show that AKI is a common complication of severe coronavirus disease 2019 (COVID-19) in hospitalized patients. Studies have also observed proteinuria and microscopic hematuria in such patients. Although a recent autopsy series of patients who died with severe COVID-19 in China found acute tubular necrosis in the kidney, a few patient reports have also described collapsing glomerulopathy in COVID-19. Methods We evaluated biopsied kidney samples from ten patients at our institution who had COVID-19 and clinical features of AKI, including proteinuria with or without hematuria. We documented clinical features, pathologic findings, and outcomes. Results Our analysis included ten patients who underwent kidney biopsy (mean age: 65 years); five patients were black, three were Hispanic, and two were white. All patients had proteinuria. Eight patients had severe AKI, necessitating RRT. All biopsy samples showed varying degrees of acute tubular necrosis, and one patient had associated widespread myoglobin casts. In addition, two patients had findings of thrombotic microangiopathy, one had pauci-immune crescentic GN, and another had global as well as segmental glomerulosclerosis with features of healed collapsing glomerulopathy. Interestingly, although the patients had confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by RT-PCR, immunohistochemical staining of kidney biopsy samples for SARS-CoV-2 was negative in all ten patients. Also, ultrastructural examination by electron microscopy showed no evidence of viral particles in the biopsy samples. Conclusions The most common finding in our kidney biopsy samples from ten hospitalized patients with AKI and COVID-19 was acute tubular necrosis. There was no evidence of SARS-CoV-2 in the biopsied kidney tissue. |
| Databáze: | OpenAIRE |
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