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

Couturier, A.; Ferlicot, Sophie; Chevalier, Kévin; Guillet, Matthieu; Essig, Marie; Jauréguiberry, Stéphane; Collarino, R.; Dargelos, Mathilde; Michaut, Alice; Géri, Guillaume; Roque-Afonso, A.M.; Zaidan, Mohamad; Massy, Ziad A.

doi:10.1093/ckj/sfaa088

Cited by 38 publications

(48 citation statements)

References 23 publications

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“…The first histological analysis of post-mortem renal biopsies of 26 patients from China showed acute tubular injury, collapsing glomerulopathy, vascular injury and podocyte foot process effacement [4]. Four subsequent case reports (Table 1) in which patient presented with AKI, all reported ATI/ATN and CG [5][6][7][8]. Our case report describes a rare presenting complaint of COVID-19 patients with kidney involvementthat of new-onset nephrotic syndrome.…”

Section: Discussionmentioning

confidence: 70%

“…Our case report describes a rare presenting complaint of COVID-19 patients with kidney involvementthat of new-onset nephrotic syndrome. Interestingly, the Asian-Indian patient (case 1) presented initially with minimal changetype glomerulopathy which progressed to CG with time, hinting at the possibility that non-AA and/or asymptomatic COVID-19 patients may pass through a more benign glomerular phase (as pointed out by Couturier et al [8]) before developing florid CG, while genetic predisposition [6] like APOL-1 positivity coupled with symptomatic COVID-19 may push patients of African-American ethnicity to develop more severe glomerular pathology (that of CG) from the outset ( Table 1). The exact mechanism of podocyte injury in COVID-19 infection is still unknown, although several hypotheses have been put forward.…”

Section: Discussionmentioning

confidence: 92%

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Spectrum of podocytopathies in new-onset nephrotic syndrome following COVID-19 disease: a report of 2 cases

et al. 2020

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Background: Coronavirus disease-2019 (COVID-19) is an ongoing pandemic which has affected over 12 million people across the globe. Manifestations in different organs systems are being reported regularly. Renal biopsy findings in hospitalized COVID-19 patients presenting solely with acute kidney injury (AKI) have recently been described in published literature in few case reports. The findings include diffuse acute tubular injury (ATI) along with the glomerular lesion of collapsing glomerulopathy (CG). However, nephrotic syndrome as the presenting complaint of COVID-19 has not been reported widely, neither has any other glomerular lesion other than CG. Case presentation: We describe the kidney biopsy findings of two patients who had recent diagnoses of COVID-19 and presented with new-onset nephrotic syndrome. Renal biopsy in both patients showed ATI (as in previous reports) and distinct glomerular findings on light microscopythat of minimal change disease (MCD) initially in one patient followed by CG in a subsequent biopsy and CG at the outset in the other patient. The electron microscopic findings in both patients were that of severe podocytopathy (diffuse and severe podocyte foot process effacement). Conclusion: Our cases highlight a novel clinical presentation of COVID-19 renal disease, not described before, that of new-onset nephrotic syndrome. While all published case reports describe CG as the glomerular pathology, we describe a non-CG pathology (MCD) in one of our cases, thereby adding to the repertoire of renal pathology described in association with COVID-19 patients. However, the exact mechanism by which podocyte injury or podocytopathy occurs in all such cases is still unknown. Optimal treatment options for these patients also remains unknown at this time.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 92%

Spectrum of podocytopathies in new-onset nephrotic syndrome following COVID-19 disease: a report of 2 cases

et al. 2020

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“…In this journal, Couturier et al [ 18 ] recently reported on the clinical course and pathology findings for two COVID-19 patients with collapsing focal segmental glomerulosclerosis (FSGS) and severe tubulointerstitial lesions. This specific subtype of glomerulonephritis is often observed in patients affected by the human immunodeficiency virus (HIV) [ 19 ].…”

Section: Covid-19 and Acute Kidney Injurymentioning

confidence: 99%

“…Both patients were submitted to kidney biopsy during the course of their disease because of progressively increasing proteinuria and worsening of kidney function concurrently with the worsening of lung disease and hypoxia [ 18 ]. In order to better characterize the role of SARS-CoV-2 in the development of collapsing FSGS, the authors performed reverse transcription polymerase chain reaction (RT-PCR) assay on the renal tissue specimen of one of the two patients without detecting any molecular expression of the virus.…”

Section: Covid-19 and Acute Kidney Injurymentioning

confidence: 99%

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Hypoxia response and acute lung and kidney injury: possible implications for therapy of COVID-19

Vecchio¹,

Locatelli

2020

Clinical Kidney Journal

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Coronavirus disease 2019 (COVID-19) is a pandemic of unprecedented severity affecting millions of people around the world and causing several hundred thousands of deaths. The presentation of the disease ranges from asymptomatic manifestations through to acute respiratory distress syndrome with the necessity of mechanical ventilation. Cytokine storm and maladaptive responses to the viral spread in the body could be responsible for the severity of disease. Many patients develop acute kidney injury (AKI) during the course of their disease, especially in more severe cases. Many factors could cause kidney damage during infection from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. It is still unclear whether direct viral damage or the overexpression of cytokines and inflammatory factors are preeminent. According to autoptic studies, in most of the cases, AKI is due proximal tubular damage. However, cases of collapsing focal segmental glomerulosclerosis were reported as well in the absence of signs of direct viral infection of the kidney. Considering that severe hypoxia is a hallmark of severe SARS-CoV-2 infection, the involvement of the hypoxia-inducible factor (HIF) system is very likely, possibly influencing the inflammatory response and outcome in both the lungs and kidneys. Several bodies of evidence have shown a possible role of the HIF pathway during AKI in various kidney disease models. Similar observations were made in the setting of acute lung injury. In both organs, HIF activation by means of inhibition of the prolyl-hydroxylases domain (PHD) could be protective. Considering these promising experimental data, we hypothesize that PHD inhibitors could be considered as a possible new therapy against severe SARS-CoV-2 infection.

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SNPs at 3′UTR of APOL1 and miR-6741-3p target sites associated with kidney diseases more susceptible to SARS-COV-2 infection: in silco and in vitro studies

et al. 2021

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Acute Kidney Injury (AKI) is a common manifestation of COVID-19 and several cases have been reported in the setting of the high-risk APOL1 genotype (common genetic variants). This increases the likelihood that African American people with the high-risk genotype APOL1 are at increased risk for kidney disease in the COVID-19 environment. Single-nucleotide polymorphisms (SNPs) are found in various microRNAs (miRNAs) and target genes change the miRNA activity that leads to different diseases. Evidence has shown that SNPs increase/decrease the effectiveness of the interaction between miRNAs and disease-related target genes. The aim of this study is not only to identify miRSNPs on the APOL1 gene and SNPs in miRNA genes targeting 3′UTR but also to evaluate the effect of these gene variations in kidney patients and their association with SARS-COV-2 infection. In 3′UTR of the APOL1 gene, we detected 96 miRNA binding sites and 35 different SNPs with 10 different online software in the binding sites of the miRNA (in silico). Also we studied gene expression of patients and control samples by using qRT-PCR (in vitro). In silico study, the binding site of miR-6741-3p on APOL1 has two SNPs (rs1288875001, G > C; rs1452517383, A > C) on APOL1 3′UTR, and its genomic sequence is the same nucleotide as rs1288875001. Similarly, two other SNPs (rs1142591, T > A; rs376326225, G > A) were identified in the binding sites of miR-6741-3p at the first position. Here, the miRSNP (rs1288875001) in APOL1 3′UTR and SNP (rs376326225) in the miR-6741-3p genomic sequence are cross-matched in the same binding region. In vitro study, the relative expression levels were calculated by the 2 −ΔΔCt method & Mann-Whitney U test. The expression of APOL1 gene was different in chronic kidney patients along with COVID-19. By these results, APOL1 expression was found lower in patients than healthy (p < 0.05) in kidney patients along with COVID-19. In addition, miR-6741-3p targets many APOL1-related genes (TLR7,

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

Cited by 38 publications

References 23 publications

Spectrum of podocytopathies in new-onset nephrotic syndrome following COVID-19 disease: a report of 2 cases

Spectrum of podocytopathies in new-onset nephrotic syndrome following COVID-19 disease: a report of 2 cases

Hypoxia response and acute lung and kidney injury: possible implications for therapy of COVID-19

SNPs at 3′UTR of APOL1 and miR-6741-3p target sites associated with kidney diseases more susceptible to SARS-COV-2 infection: in silco and in vitro studies

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