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COVID-19 Can Directly Infect the Kidneys Resulting to Kidney Injury, Study Reveals

A recent study has revealed that SARS-CoV-2 can directly infect the kidneys, resulting to tubular pathogenesis and acute kidney injury or AKI.

COVID-19 Can Directly Infect the Kidneys | InStyleHealth
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

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