Glomerular Diseases Associated With COVID-19

COVID-19 is a systemic disease that targets multiple organs; the kidney is one of the target organs of infection related to COVID-19. Kidney injury has been reported in up to 40% of patients with COVID-19, and several glomerular diseases have been reported in association with COVID-19.

Nattawat Klomijit, MD, and colleagues provided an overview of glomerular diseases that have been reported frequently among patients with COVID-19 that have a mechanistic explanation that indicates the likelihood of being related to the virus. Collapsing glomerulopathy (CG) is the most prevalent glomerular disease related to COVID-19. The association between CG and COVID-19 has led to coining of a proposed term, COVID-19-associated nephropathy (COVAN).

High-risk APOL1 genotypes are the primary risk factor for COVAN patients. Other complications include podocytopathy, membranous nephropathy, pauci-immune crescentic glomerulonephritis, and thrombotic microangiopathy.

CG is the most common glomerular pathology in kidney allografts. Patients generally present with acute kidney injury or abnormal urinary findings at the time of or shortly after a diagnosis of COVID-19. Management of glomerular disease in transplant recipients with COVID-19 is challenging. Providers should balance the risk and benefits of immunosuppression, particularly in patients with active diseases. Short-term outcomes vary but are generally poor with high morbidity and mortality.

In summary, the researchers said, “Future study of long-term outcomes is needed to improve our understanding of glomerular disease associated with COVID-19.”

Source: Kidney International Reports