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Abstract: PO0838

COVID-19-Associated Kidney Injury: A Case Series of Kidney Biopsy Findings

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Sharma, Purva D., Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, United States
  • Shah, Hitesh H., Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, United States
  • Jhaveri, Kenar D., Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, United States
  • Bijol, Vanesa, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, United States

Group or Team Name

  • On behalf of the Northwell Renal COVID 19 Consortium
Background

Acute kidney injury (AKI) has been recognized as a common complication of severe COVID-19 in hospitalized patients. Proteinuria and microscopic hematuria have also been observed. While a recent autopsy series of patients who died with severe COVID-19 in China found acute tubular necrosis (ATN) in the kidney, few case reports of collapsing glomerulopathy in COVID-19 have also been reported

Methods

To better understand the clinical and histopathologic findings, we looked at 10 kidney biopsy cases in patients with COVID-19 along with clinical features of AKI with or without proteinuria or hematuria in our institution. We described their clinical features, pathologic findings and outcomes.

Results

The mean age of the patients who underwent kidney biopsy was 65 years. Five patients were African American, three patients were Hispanic, and two were Caucasian. Nine patients had varying degree of proteinuria. Eight patients had severe AKI necessitating renal replacement therapy. On kidney biopsy, all patients had varying degree of ATN, with one patient having associated widespread myoglobin casts. In addition, two patients had findings of thrombotic microangiopathy (TMA), one patient had pauci-immune crescentic glomerulonephritis and another patient had global as well as segmental glomerulosclerosis with features of healed collapsing glomerulopathy. Interestingly, all patients had negative immunohistochemistry staining for SARS-CoV-2 on their kidney biopsy material.

Conclusion

This biopsy series reveals ATN as the most common kidney biopsy finding with AKI in COVID-19 infection with no evidence of significant viral presence in the kidney tissue