Elsevier

Kidney Medicine

Volume 2, Issue 4, July–August 2020, Pages 488-492
Kidney Medicine

Case Report
COVID-19–Related Glomerulopathy: A Report of 2 Cases of Collapsing Focal Segmental Glomerulosclerosis

https://doi.org/10.1016/j.xkme.2020.05.004Get rights and content
Under a Creative Commons license
open access

Coronavirus disease 19 (COVID-19), an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been associated with acute kidney injury, presumably due to acute tubular injury. However, this does not explain proteinuria, sometimes severe, and hematuria often observed. We present 2 African American patients with glomerulopathy demonstrated by kidney biopsy in the setting of acute kidney injury and COVID-19 infection. Kidney biopsy specimens showed a collapsing variant of focal segmental glomerulosclerosis in addition to acute tubular injury. Both patients were homozygous for apolipoprotein L1 (APOL1). COVID-19 infection likely caused the interferon surge as a second hit causing podocyte injury leading to collapsing focal segmental glomerulosclerosis. APOL1 testing should be strongly considered in African American patients with nephrotic-range proteinuria. More data from future kidney biopsies will further elucidate the pathology of kidney injury and glomerular involvement from COVID-19 infections.

Index Words

COVID
collapsing
glomerulopathy
FSGS
SARS
proteinuria
AKI

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