{"doi":"10.1016/j.ekir.2020.04.030","title":"COVID-19–Associated Collapsing Glomerulopathy: An Emerging Entity","abstract":"See Nephrology Rounds on Page 940 See Nephrology Rounds on Page 940 Coronavirus disease 2019 (COVID-19) is an emerging human infectious disease caused by a novel β coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Clinical manifestations range from asymptomatic infection, self-limited flu-like symptoms, to severe acute pneumonia with high mortality. Whereas the lung is the primary target in this pandemic disease, other organs can be affected, including the gastrointestinal tract, liver, heart, blood, and kidneys.1Zhou F. Yu T. Du R. et al.Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study.Lancet. 2020; 395: 1054-1062Abstract Full Text Full Text PDF PubMed Scopus (18962) Google Scholar Acute respiratory distress syndrome and multiorgan damage, which are responsible for most mortalities, are thought to be mediated by an acute release of inflammatory cytokines, representing cytokine release syndrome.2Liu B. Li M. Zhou Z. et al.Can we use interleukin-6 (IL-6) blockade for coronavirus disease 2019 (COVID-19)-induced cytokine release syndrome (CRS)?.J Autoimmun. 2020; : 102452Crossref PubMed Scopus (555) Google Scholar Reports from China have highlighted frequent kidney involvement in COVID-19, and this was associated with increased mortality.3Cheng Y. Luo R. Wang K. et al.Kidney disease is associated with in-hospital death of patients with COVID-19.Kidney Int. 2020; 97: 829-838Abstract Full Text Full Text PDF PubMed Scopus (1932) Google Scholar,4Li Z. Wu M. Yao J. et al.Caution on kidney dysfunctions of COVID-19 patients.medRxiv. 2020; (2020.2002.2008.20021212)Google Scholar In a prospective cohort of 401 patients with COVID-19, 44% of patients had proteinuria, 27% had hematuria, 14% had elevated serum creatinine on admission, and 5.1% had acute kidney injury (AKI) during admission; all of these renal abnormalities were independent risk factors for in-hospital death.3Cheng Y. Luo R. Wang K. et al.Kidney disease is associated with in-hospital death of patients with COVID-19.Kidney Int. 2020; 97: 829-838Abstract Full Text Full Text PDF PubMed Scopus (1932) Google Scholar In another study, 59% had proteinuria, 44% hematuria, and 10% elevated serum creatinine on admission.4Li Z. Wu M. Yao J. et al.Caution on kidney dysfunctions of COVID-19 patients.medRxiv. 2020; (2020.2002.2008.20021212)Google Scholar Proposed mechanisms for AKI include hypoperfusion-induced tubular injury associated with sepsis and cytokine storm, and direct tubular cell toxicity by the virus.5Naicker S. Yang C.-W. Hwang S.-J. et al.The novel coronavirus 2019 epidemic and kidneys.Kidney Int. 2020; 97: 824-828Abstract Full Text Full Text PDF PubMed Scopus (465) Google Scholar The latter is supported by the findings of a recent postmortem study that analyzed the renal pathologic abnormalities in 26 patients with COVID-19.6Su H, Yang M, Wan C, et al. Renal histopathological analysis of 26 postmortem findings of patients with COVID-19 in China [e-pub ahead of print]. Kidney Int. https://doi.org/10.1016/j.kint.2020.04.003. Accessed April 22, 2020.Google Scholar A third of patients had clinical evidence of elevated serum creatinine and/or new-onset proteinuria. Prominent acute tubular injury was seen by light microscopy, viral particles were detected within tubular epithelial cells and podocytes by electron microscopy, and immunofluorescence staining for SARS-CoV-2 nucleoprotein was positive in tubular cells. Collectively, these pathologic findings indicate that SARS-CoV-2 infects kidney parenchymal cells, similar to a closely related β coronavirus, Middle East respiratory syndrome coronavirus.7Alsaad K.O. Hajeer A.H. Al Balwi M. et al.Histopathology of Middle East respiratory syndrome coronovirus (MERS-CoV) infection—clinicopathological and ultrastructural study.Histopathology. 2018; 72: 516-524Crossref PubMed Scopus (230) Google Scholar Collapsing glomerulopathy (CG) is a","journal":"Kidney International Reports","year":2020,"id":52543,"datarank":0.7324202883879557,"base_score":4.882801922586371,"endowment":4.882801922586371,"self_citation_contribution":0.7324202883879557,"citation_network_contribution":0.0,"self_endowment_contribution":0.7324202883879557,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":131,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9527,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":225761,"name":"Jeffrey B. 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