Archives of Pathology & Laboratory Medicine
Context: COVID-19 has been shown to cause renal pathology by multiple proposed mechanisms. However, studies evaluating renal biopsies for the effects of COVID-19 remain limited. We report our experience in our health system in a variety of renal pathologic diagnoses caused by COVID-19 infection.
Design: We performed detailed analysis of 5 renal biopsies related to COVID-19 infection, of 812 renal biopsies over the previous 22 months (0.6% of all cases).
Results: The first 3 patients were 2 African American men, 34 and 45 years old, and 1 48-year-old white male transplant recipient who developed acute kidney injury and nephrotic range of proteinuria after COVID-19 infections. Renal biopsies showed collapsing glomerulopathies in the patients. Patient 4, a 71-year-old white woman, developed acute kidney injury (serum creatinine at 5.56 mg/dL) with hematuria and proteinuria following COVID-19 infection. Her renal biopsy revealed moderate acute tubular necrosis and mild IgA nephropathy. Patient 5, a 15-year-old African American adolescent girl infected with COVID-19, developed nephrotic range proteinuria, which became negative soon after the renal biopsy. The renal biopsy revealed segmental fusion of foot processes compatible with minimal-change disease in remission.
Conclusions: The results of our 5 patients with COVID-19 infection included 3 collapsing glomerulopathies, 1 IgA nephropathy/acute tubular necrosis, and 1 minimal-change disease in remission, supporting previous reported varieties of renal diseases due to COVID-19 infection.
Anderson J, Li W, Kanaan HD, Zhang P. Varieties of renal diseases identified in renal biopsies of patients infected by COVID-19. Arch Pathol Lab Med. 2022 Sep;146(9):e83. doi: 10.5858/arpa.2022-2031-AB.
College of American Pathologists 2022 Annual Meeting (CAP22), October 8-11, 2022, New Orleans, LA.