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Kidney Week

Abstract: PO0825

COVAN, COVID-Associated Nephropathy: An Evolving Epidemic of Kidney Disease

Session Information

Category: Coronavirus (COVID-19)

  • No subcategory defined

Authors

  • Shetty, Aneesha A., Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • Tawhari, Ibrahim, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • Safar-Boueri, Maria Luisa, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • Seif, Nay, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • Alahmadi, Ameen S., Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • Aggarwal, Vikram, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • Gargiulo, Richard, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • Kanwar, Yashpal S., Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • Quaggin, Susan E., Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
Introduction

We highlight COVID-19 related renal characteristics in 6 African American patients with positive nasopharyngeal RT-PCR for SARS-COV-2 infection, presenting without severe respiratory symptoms but with acute kidney injury and nephrotic range proteinuria.

Case Description

One of the patients was a transplant recipient. None required mechanical ventilation and no COVID-19 specific therapy was prescribed. All underwent a renal biopsy that showed varying combinations of collapsing glomerulopathy, podocytopathy and protein overload tubulopathy (Fig 1A). Additionally, tubulo-reticular inclusions and virions (suspected to be SARS-COV-2 virions) were seen in electron micrographs (Fig 1B). APOL1 genotype was tested in 3 patients who were all found to carry high-risk genotypes, suggesting possible susceptibility of patients with high-risk APOL1 alleles to kidney involvement in SARS-Cov-2 (Fig 1C)

Discussion

There was discordance between the high risk G1/G1 genotype of the transplant recipient and the low risk G1/G0 donor kidney genotype, suggesting the important possibility of a systemic APOL1-related mechanism in kidney injury. In conclusion, these 6 cases draw attention to proteinuric kidney disease in COVID-19 infection, possibly associated with a milder form of respiratory disease and high risk APOL1 genotype, emphasizing the need for ongoing vigilance and further investigation into this phenomenon

Figure 1: 1A: Demographic and Clinical features of the Six Cases. 1B:Biopsy findings. 1C: ApoL1 genotyping for Case 1