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Kidney Med . COVID-19-Associated Collapsing Focal Segmental Glomerulosclerosis: A Report of 2 Cases

tetano

Editor, Senior Moderator
Kidney Med


. 2020 Jun 6;2(4):493-497.
doi: 10.1016/j.xkme.2020.05.005. eCollection Jul-Aug 2020.
COVID-19-Associated Collapsing Focal Segmental Glomerulosclerosis: A Report of 2 Cases


Yuvraj Sharma[SUP] 1 [/SUP], Samih H Nasr[SUP] 2 [/SUP], Christopher P Larsen[SUP] 3 [/SUP], Amy Kemper[SUP] 4 [/SUP], Adrian H Ormsby[SUP] 4 [/SUP], Sean R Williamson[SUP] 4 5 [/SUP]



Affiliations

Abstract

Collapsing glomerulopathy is an aggressive form of focal segmental glomerulosclerosis with diverse causes. The presence of the apolipoprotein L1 (APOL1) high-risk genotype is a major risk factor for collapsing glomerulopathy in African Americans. Coronavirus disease 2019 (COVID-19) is an emerging pandemic with predominant respiratory manifestations. However, kidney involvement is being frequently noted and is associated with higher mortality. Currently, kidney pathology data for COVID-19 are scant and mostly come from postmortem findings. We report 2 African American patients who developed acute kidney injury and proteinuria in temporal association with COVID-19 infection. Kidney biopsy specimens showed collapsing glomerulopathy, endothelial tubuloreticular inclusions, and acute tubular injury, without evidence by electron microscopy or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in situ hybridization of viral infection of kidney cells. Both patients had the APOL1 high-risk genotype. We propose that collapsing glomerulopathy represents a novel manifestation of COVID-19 infection, especially in people of African descent with APOL1 risk alleles.

Keywords: collapsing glomerulopathy, focal segmental glomerulosclerosis, COVID-19, acute kidney injury, proteinuria, APOL1 genotype.
 
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