A recent study has revealed that SARS-CoV-2 can directly infect the kidneys, resulting to tubular pathogenesis and acute kidney injury or AKI.
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| Photo: COVID-19 Can Directly Infect the Kidneys | InStyleHealth |
Experts facilitated a retrospective analysis of 85
patients with laboratory-confirmed novel coronavirus disease or COVID-19. Post-mortem
kidney histopathology was also performed in six additional COVID-19 autopsies;
in all cases, acute respiratory distress syndrome was the cause of death.
Among the patients, 23 had acute kidney injury or AKI
while the remaining 62 did not, generating a prevalence rate of 27%. AKI was
diagnosed based on estimated glomerular filtration rate or eGFR. Severe disease
and mortality both overlapped with AKI, though statistical significance was not
achieved. Patients who were older or had comorbidities were much more likely to
develop AKI.
The patients in this study were divided into three
severity groups (mild/moderate, severe, and critical) revealed that eGFR was
significantly lowered among critically ill patients while serum urea and creatinine
concentrations were dramatically raised, suggesting that in these patients, AKI
was relatively common.
The post-mortem histopathological studies showed varying
degrees of tubular necrosis, luminal brush border sloughing, vacuole degeneration,
and leukocyte infiltration. Four of the autopsy samples showed signs of benign
hypertensive glomerulosclerosis, although none had severe glomerular injury.
Researchers said that patients infected by SARS-CoV-2
presented kidney defects that appear different from nephritis and nephrotic
syndrome, in which the pathological signs are mainly shown in the glomerulus,
rarely accompanied by tubular injury.
Furthermore, according to researchers they have demonstrated
that the SARS-CoV-2 virus can directly infect human renal tubules and
consequently lead to renal tubular injury and AKI, suggesting that the risk of
AKI in COVID-19 patients should be kept in mind and alleviation of renal injury
would benefit COVID-19 patients.
Source: Nat Commun 2021;12:2506