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Evidence For and Against Direct Kidney Infection by SARS-CoV-2 in Patients with COVID-19.
Hassler, Luise; Reyes, Fabiola; Sparks, Matthew A; Welling, Paul; Batlle, Daniel.
  • Hassler L; Division of Nephrology and Hypertension, Northwestern University, Chicago, Illinois.
  • Reyes F; Divison of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts.
  • Sparks MA; Division of Nephrology, Duke University School of Medicine, Durham, North Carolina.
  • Welling P; Renal Section, Durham Veterans Affairs Health Care System, Durham, North Carolina.
  • Batlle D; Departments of Medicine (Nephrology) and Physiology, Johns Hopkins School of Medicine, Baltimore, Maryland.
Clin J Am Soc Nephrol ; 16(11): 1755-1765, 2021 11.
Article in English | MEDLINE | ID: covidwho-1526737
ABSTRACT
Despite evidence of multiorgan tropism of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patients with coronavirus disease 2019 (COVID-19), direct viral kidney invasion has been difficult to demonstrate. The question of whether SARS-CoV2 can directly infect the kidney is relevant to the understanding of pathogenesis of AKI and collapsing glomerulopathy in patients with COVID-19. Methodologies to document SARS-CoV-2 infection that have been used include immunohistochemistry, immunofluorescence, RT-PCR, in situ hybridization, and electron microscopy. In our review of studies to date, we found that SARS-CoV-2 in the kidneys of patients with COVID-19 was detected in 18 of 94 (19%) by immunohistochemistry, 71 of 144 (49%) by RT-PCR, and 11 of 84 (13%) by in situ hybridization. In a smaller number of patients with COVID-19 examined by immunofluorescence, SARS-CoV-2 was detected in 10 of 13 (77%). In total, in kidneys from 102 of 235 patients (43%), the presence of SARS-CoV-2 was suggested by at least one of the methods used. Despite these positive findings, caution is needed because many other studies have been negative for SARS-CoV-2 and it should be noted that when detected, it was only in kidneys obtained at autopsy. There is a clear need for studies from kidney biopsies, including those performed at early stages of the COVID-19-associated kidney disease. Development of tests to detect kidney viral infection in urine samples would be more practical as a noninvasive way to evaluate SARS-CoV-2 infection during the evolution of COVID-19-associated kidney disease.
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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: SARS-CoV-2 / COVID-19 / Kidney / Kidney Diseases Subject: SARS-CoV-2 / COVID-19 / Kidney / Kidney Diseases Type of study: Diagnostic study / Etiology study / Evidence synthesis / Prognostic study / Risk factors Language: English Journal: Clin J Am Soc Nephrol Clinical aspect: Etiology / Prediction / Prognosis Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: SARS-CoV-2 / COVID-19 / Kidney / Kidney Diseases Subject: SARS-CoV-2 / COVID-19 / Kidney / Kidney Diseases Type of study: Diagnostic study / Etiology study / Evidence synthesis / Prognostic study / Risk factors Language: English Journal: Clin J Am Soc Nephrol Clinical aspect: Etiology / Prediction / Prognosis Year: 2021
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