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[COVID-19 effects on the kidney]

K Amann1, P Boor2, T Wiech3

  • 1Abt. Nephropathologie, Universitätsklinikum Erlangen, Krankenhausstr. 8-10, 91054, Erlangen, Deutschland. Kerstin.Amann@uk-erlangen.de.

Der Pathologe
|February 2, 2021
PubMed

Insights

Severe acute kidney injury (AKI) is a common complication of coronavirus disease 2019 (COVID-19). Research is ongoing to understand the virus

Area of Science:

  • Nephrology
  • Virology
  • Pathology

Background:

  • Acute kidney injury (AKI) is a frequent and severe complication of coronavirus disease 2019 (COVID-19), alongside pulmonary disease.
  • The SARS-CoV-2 virus has been identified in kidney tissue, raising concerns for patients with pre-existing kidney conditions, including chronic kidney disease (CKD) and renal transplant recipients.
  • The increasing incidence of renal involvement in COVID-19 patients has spurred significant interest in understanding the underlying pathophysiology, morphology, and viral detection methods within the kidney.

Purpose of the Study:

  • To analyze the pathophysiology and morphology of kidney involvement in severe COVID-19.
  • To evaluate the effectiveness and challenges of different methods for detecting SARS-CoV-2 in renal tissue.
  • To clarify the direct and indirect contributions of SARS-CoV-2 to kidney injury.

Main Methods:

  • Review and analysis of existing autopsy and kidney biopsy studies on COVID-19 patients with renal involvement.
  • Assessment of SARS-CoV-2 RNA detection techniques in renal tissue.
  • Evaluation of electron microscopy for viral visualization, considering potential artefacts.

Main Results:

  • Detection of SARS-CoV-2 RNA in kidney tissue yields reproducible results across studies.
  • Electron microscopy for visualizing SARS-CoV-2 in the kidney is challenging and subject to debate due to artefacts.
  • The precise mechanisms, both direct and indirect, by which COVID-19 affects the kidneys are still under intensive investigation.

Conclusions:

  • Kidney complications, including AKI, are significant in severe COVID-19, particularly for vulnerable patient groups.
  • While viral RNA detection in the kidney is reliable, morphological analysis requires careful interpretation.
  • Further research is crucial to fully elucidate the complex interplay between SARS-CoV-2 and kidney injury.

Keywords:
Acute kidney injuryCoronavirus infectionsElectron microscopyExtracellular trapsSARS-CoV‑2

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