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Multiple Kidney Infarctions Due to COVID-19 Infection in a Patient with Repeatedly Negative RT-PCR Tests-A Case
Ante Mayer1, Maja Mizdrak1,2, Ivan Mizdrak3
1Department of Nephrology and Hemodialysis, University Hospital Centre of Split, Split, Croatia.
Insights
This case report highlights COVID-19 can cause kidney infarction without typical symptoms. Early diagnosis requires integrated clinical and laboratory approaches, especially with negative PCR tests.
Area of Science:
- Nephrology
- Infectious Diseases
- Cardiovascular Medicine
Background:
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, causing COVID-19, has led to widespread health concerns.
- While respiratory symptoms are common, COVID-19 is increasingly linked to arterial thrombosis and thromboembolic events.
- Renal artery embolism is a rare but serious complication, often presenting with nonspecific symptoms, making diagnosis challenging.
Observation:
- A previously healthy 63-year-old male presented with multiple right kidney infarctions.
- The patient exhibited no typical respiratory or other overt clinical manifestations of COVID-19.
- Initial reverse transcription-polymerase chain reaction (RT-PCR) tests for SARS-CoV-2 were negative.
Findings:
- Diagnosis of COVID-19 was confirmed through serological screening, despite negative RT-PCR results.
- The patient's kidney infarctions were directly attributed to COVID-19 infection.
- This case underscores the potential for atypical presentations of COVID-19.
Implications:
- Highlights the necessity of considering COVID-19 in patients with unexplained arterial thrombosis, even without respiratory symptoms.
- Emphasizes the importance of integrating clinical, laboratory, microbiological, and radiological data for accurate diagnosis of unusual COVID-19 presentations.
- Suggests serological screening may be crucial for diagnosing COVID-19 in cases with false-negative RT-PCR results and atypical manifestations.
Abstract:
Since the outbreak of novel coronavirus in 2019, SARS-CoV-2 has spread worldwide at an unexpected rate, becoming a major global health concern. Although respiratory tract infections represent typical clinical presentation, recently, numerous cases of acute arterial thrombosis and thromboembolic disease have been reported due to COVID-19 infection. Renal artery embolism is a condition that is easily missed due to its infrequent and nonspecific presentation. In this paper, we reported a case of a 63-year-old, previously healthy, male patient who has developed multiple right kidney infarctions due to COVID-19 infection without any respiratory or other typical clinical manifestations. Consecutive RT-PCR tests were negative and the diagnosis was set finally by serological screening. Our presentation has emphasized the necessity of clinical, laboratory, microbiological, and radiological integration in diagnostic approach to this novel and challenging disease with often unusual clinical presentations to avoid false negative discrimination.
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