Amann K, Boor P, Wiech T
Abt. Nephropathologie, Patholog. Institut, Universitätsklinikum Erlangen, Krankenhausstr. 8-10, 91054 Erlangen, Deutschland.
Institut für Pathologie & Medizinische Klinik II (Nephrologie) Sektion Translationale Nephropathologie, Universitätsklinikum der RWTH Aachen, Aachen, Deutschland.
Nephrologe. 2021;16(1):14-19. doi: 10.1007/s11560-020-00469-9. Epub 2020 Dec 11.
Apart from the pulmonary disease, acute kidney injury is one of the most frequent and most severe organ complications in severe coronavirus disease 2019 (COVID-19). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could also be detected in renal tissue. Patients with chronic kidney disease and on dialysis as well as kidney transplantation patients represent a particularly vulnerable population. The increasing number of patients infected with SARS-CoV‑2 has aroused increased interest in the exact pathophysiology and morphology of kidney damage as well as the direct detection of the virus in the kidneys, which in contrast to the lungs is overall more difficult to perform. Meanwhile, data from several large autopsy and kidney biopsy studies are now available. While the detection of SARS-CoV‑2 RNA in tissue leads to consistently reproducible results, the use of electron microscopy for visualization of the virus is critically discussed due to various artefacts. The exact and direct effects of SARS-CoV‑2 on the kidneys are not yet known in detail and are currently the focus of intensive research.
除肺部疾病外,急性肾损伤是重症2019冠状病毒病(COVID-19)中最常见、最严重的器官并发症之一。在肾组织中也可检测到严重急性呼吸综合征冠状病毒2(SARS-CoV-2)。慢性肾病患者、透析患者以及肾移植患者是特别脆弱的人群。感染SARS-CoV-2的患者数量不断增加,这引发了人们对肾损伤的确切病理生理学和形态学以及在肾脏中直接检测病毒的更大兴趣,与肺部相比,在肾脏中进行检测总体上更困难。与此同时,现在有来自几项大型尸检和肾活检研究的数据。虽然在组织中检测SARS-CoV-2 RNA可得到一致可重复的结果,但由于各种假象,使用电子显微镜观察病毒受到了严格讨论。SARS-CoV-2对肾脏的确切直接影响尚不清楚,目前是深入研究的重点。