Kidney Biopsy Findings in a Critically Ill COVID-19 Patient With Dialysis-Dependent Acute Kidney Injury: A Case Against “SARS-CoV-2 Nephropathy”
Giovanni Maria Rossi, Marco Delsante, Francesco Paolo Pilato, Letizia Gnetti, Liliana Gabrielli, Giada Rossini, Maria Carla Re, Giovanna Cenacchi, Paola Affanni, Maria Eugenia Colucci, Edoardo Picetti, Sandra Rossi, Elisabetta Parenti, Caterina Maccari, Paolo Greco, Francesca Di Mario, Umberto Maggiore, Giuseppe Regolisti, Enrico Fiaccadori
Abstract
It is unclear whether in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, acute kidney injury (AKI) results from direct infection of the kidneys or from complications arising in the course of coronavirus disease 2019 (COVID-19). Reports of urinary abnormalities in COVID-19 patients,S1 positive staining of tubules with viral antigens and complement components in one autoptic series,1 visualization of viral particles in tubular epithelial cells and podocytes on ultrastructural examination in another,2 and isolation of SARS-CoV-2 in urineS2,S3 raised the possibility of a SARS-CoV-2 nephropathy.