Renal Considerations in COVID-19: Biology, Pathology, and Pathophysiology.
ASAIO J
; 67(10): 1087-1096, 2021 10 01.
Article
in En
| MEDLINE
| ID: mdl-34191753
ABSTRACT
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has emerged into a worldwide pandemic of epic proportion. Beyond pulmonary involvement in coronavirus disease 2019 (COVID-19), a significant subset of patients experiences acute kidney injury. Patients who die from severe disease most notably show diffuse acute tubular injury on postmortem examination with a possible contribution of focal macro- and microvascular thrombi. Renal biopsies in patients with proteinuria and hematuria have demonstrated a glomerular dominant pattern of injury, most notably a collapsing glomerulopathy reminiscent of findings seen in human immunodeficiency virus (HIV) in individuals with apolipoprotein L-1 (APOL1) risk allele variants. Although various mechanisms have been proposed for the pathogenesis of acute kidney injury in SARS-CoV-2 infection, direct renal cell infection has not been definitively demonstrated and our understanding of the spectrum of renal involvement remains incomplete. Herein we discuss the biology, pathology, and pathogenesis of SARS-CoV-2 infection and associated renal involvement. We discuss the molecular biology, risk factors, and pathophysiology of renal injury associated with SARS-CoV-2 infection. We highlight the characteristics of specific renal pathologies based on native kidney biopsy and autopsy. Additionally, a brief discussion on ancillary studies and challenges in the diagnosis of SARS-CoV-2 is presented.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Acute Kidney Injury
/
COVID-19
/
Kidney
Type of study:
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
ASAIO J
Journal subject:
TRANSPLANTE
Year:
2021
Document type:
Article