Magoon Sandeep, Bichu Prasad, Malhotra Varun, Alhashimi Fatema, Hu Yanglin, Khanna Siddharth, Berhanu Kabaye
Division of Nephrology, Eastern Virginia Medical School, Norfolk, VA.
Nephrology Associate of Tidewater, Norfolk, VA.
Kidney Med. 2020 Jun 7;2(4):488-492. doi: 10.1016/j.xkme.2020.05.004. eCollection 2020 Jul-Aug.
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 (). COVID-19 infection likely caused the interferon surge as a second hit causing podocyte injury leading to collapsing focal segmental glomerulosclerosis. 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.
冠状病毒病19（COVID-19）是由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的一种传染病，与急性肾损伤有关，推测是由于急性肾小管损伤所致。然而，这并不能解释有时严重的蛋白尿以及经常观察到的血尿。我们报告了2例非裔美国患者，在急性肾损伤和COVID-19感染的情况下，肾活检显示存在肾小球病。肾活检标本除了有急性肾小管损伤外，还显示局灶节段性肾小球硬化的塌陷型。两名患者载脂蛋白L1均为纯合子（）。COVID-19感染可能作为第二次打击导致干扰素激增，从而引起足细胞损伤，导致塌陷型局灶节段性肾小球硬化。对于患有肾病范围蛋白尿的非裔美国患者，应强烈考虑进行检测。未来肾活检的更多数据将进一步阐明COVID-19感染导致的肾损伤和肾小球受累的病理情况。
