Skip to main content

Main menu

  • Home
  • Content
    • Early Access
    • Current Issue
    • Kidney360 Podcasts
    • Subject Collections
    • Archives
    • ASN Meeting Abstracts
  • Clinical Images
  • Authors
    • Submit a Manuscript
    • Author Resources
  • Editorial Team
  • More
    • About Kidney360
    • Advertising
    • Disqus Commenting
    • Reprint Information
    • Feedback
    • Email Alerts
  • ASN Kidney News
  • Other
    • JASN
    • CJASN
    • Kidney News Online
    • American Society of Nephrology

User menu

Search

  • Advanced search
American Society of Nephrology
  • Other
    • JASN
    • CJASN
    • Kidney News Online
    • American Society of Nephrology
Advertisement
American Society of Nephrology

Advanced Search

  • Home
  • Content
    • Early Access
    • Current Issue
    • Kidney360 Podcasts
    • Subject Collections
    • Archives
    • ASN Meeting Abstracts
  • Clinical Images
  • Authors
    • Submit a Manuscript
    • Author Resources
  • Editorial Team
  • More
    • About Kidney360
    • Advertising
    • Disqus Commenting
    • Reprint Information
    • Feedback
    • Email Alerts
  • ASN Kidney News
  • Visit ASN on Facebook
  • Follow Kidney360 on Twitter
  • Community Forum
  • Kidney360 RSS
Original Investigation

COVID-19-associated nephropathy includes tubular necrosis and capillary congestion, with evidence of SARS-CoV-2 in the nephron

Antoine Bouquegneau, Pauline Erpicum, Stéphanie Grosch, Lionel Habran, Olivier Hougrand, Justine Huart, Jean-Marie Krzesinski, Benoît Misset, Marie-Pierre Hayette, Philippe Delvenne, Christophe Bovy, Dominik Kylies, Tobias B. Huber, Victor G. Puelles, Pierre Delanaye and Francois Jouret
Kidney360 February 2021, 10.34067/KID.0006992020; DOI: https://doi.org/10.34067/KID.0006992020
Antoine Bouquegneau
1Nephrology - Dialysis - Transplantation, CHU de Liege - Hospital Sart Tilman, Belgium
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: antoine.bouquegneau@chuliege.be
Pauline Erpicum
2CHU de Liege - Hospital Sart Tilman, Belgium
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Stéphanie Grosch
2CHU de Liege - Hospital Sart Tilman, Belgium
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Lionel Habran
2CHU de Liege - Hospital Sart Tilman, Belgium
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Olivier Hougrand
2CHU de Liege - Hospital Sart Tilman, Belgium
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Olivier Hougrand
Justine Huart
2CHU de Liege - Hospital Sart Tilman, Belgium
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jean-Marie Krzesinski
3Nephrology, CHU de Liege - Hospital Sart Tilman, Belgium
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Jean-Marie Krzesinski
Benoît Misset
2CHU de Liege - Hospital Sart Tilman, Belgium
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Benoît Misset
Marie-Pierre Hayette
4Clinical Microbiology, CHU de Liege - Hospital Sart Tilman, Belgium
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Marie-Pierre Hayette
Philippe Delvenne
5Pathology, CHU de Liege - Hospital Sart Tilman, Belgium
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Christophe Bovy
2CHU de Liege - Hospital Sart Tilman, Belgium
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Dominik Kylies
6University Medical Center Hamburg-Eppendorf, Germany
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Tobias B. Huber
7III. Departmnt of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Tobias B. Huber
Victor G. Puelles
8III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Germany
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Pierre Delanaye
9Nephrology-Dialysis-Transplantation, University of Liege, Belgium
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Pierre Delanaye
Francois Jouret
10ULiège, Belgium
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Francois Jouret
  • Article
  • Figures & Data Supps
  • Info & Metrics
  • View PDF
Loading

Abstract

Background: Kidney damage has been reported in patients with COVID-19. Despite numerous reports about COVID-19-associated nephropathy, the factual presence of the SARS-CoV-2 in the renal parenchyma remains controversial. Methods: We consecutively performed 16 immediate (≤3h) post-mortem renal biopsies in patients diagnosed with COVID-19. Kidney samples from 5 patients who died from sepsis not related to COVID-19 were used as controls. Samples were methodically evaluated by 3 pathologists. Virus detection in the renal parenchyma was performed in all samples by bulk RNA RT-PCR (E and N1/N2 genes), immunostaining (nCoV2019 N-Protein), fluorescent in situ hybridization (nCoV2019-S) and electron microscopy. Results: The mean age of our COVID-19 cohort was 68.2±12.8 years, most of whom were males (68.7%). Proteinuria was observed in 53.3% of cases, while acute kidney injury occurred in 60% of cases. Acute tubular necrosis of variable severity was found in all cases, with no tubular or interstitial inflammation. There was no difference in acute tubular necrosis severity between the patients with COVID-19 versus controls. Congestion in glomerular and peri-tubular capillaries was respectively observed in 56.3 and 87.5% of patients with COVID-19 compared to 20% of controls, with no evidence of thrombi. The nCoV2019 N-Protein was detected in proximal tubules and also at the basolateral pole of scattered cells of the distal tubules in 9/16 cases. In situ hybridization confirmed these findings in 6/9 interpretable cases. RT-PCR of kidney total RNA detected SARS-CoV-2 E and N1/N2 genes in one case. Electron microscopy did not show typical viral inclusions. Conclusions: Our immediate post-mortem kidney samples from patients with COVID-19 highlight a congestive pattern of acute kidney injury, with no significant glomerular or interstitial inflammation. Immunostaining and in situ hybridization suggest that SARS-CoV-2 is present in various segments of the nephron.

  • COVID-19
  • SARS-CoV-2
  • Kidney
  • Histology
  • Immunostaining
  • in situ Hybridization
  • Received November 20, 2020.
  • Revision received February 11, 2021.
  • Accepted February 11, 2021.
  • Copyright © 2021 American Society of Nephrology
PreviousNext
Back to top

In this issue

Kidney360: 2 (2)
Kidney360
Vol. 2, Issue 2
25 Feb 2021
  • Table of Contents
  • Table of Contents (PDF)
  • Cover (PDF)
  • About the Cover
  • Index by author
View Selected Citations (0)
Download PDF
Sign up for Alerts
Email Article

Thank you for your interest in spreading the word on American Society of Nephrology.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
COVID-19-associated nephropathy includes tubular necrosis and capillary congestion, with evidence of SARS-CoV-2 in the nephron
(Your Name) has sent you a message from American Society of Nephrology
(Your Name) thought you would like to see the American Society of Nephrology web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
COVID-19-associated kidney injury
Antoine Bouquegneau, Pauline Erpicum, Stéphanie Grosch, Lionel Habran, Olivier Hougrand, Justine Huart, Jean-Marie Krzesinski, Benoît Misset, Marie-Pierre Hayette, Philippe Delvenne, Christophe Bovy, Dominik Kylies, Tobias B. Huber, Victor G. Puelles, Pierre Delanaye, Francois Jouret
Kidney360 Feb 2021, 10.34067/KID.0006992020; DOI: 10.34067/KID.0006992020

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Request Permissions
Share
COVID-19-associated kidney injury
Antoine Bouquegneau, Pauline Erpicum, Stéphanie Grosch, Lionel Habran, Olivier Hougrand, Justine Huart, Jean-Marie Krzesinski, Benoît Misset, Marie-Pierre Hayette, Philippe Delvenne, Christophe Bovy, Dominik Kylies, Tobias B. Huber, Victor G. Puelles, Pierre Delanaye, Francois Jouret
Kidney360 Feb 2021, 10.34067/KID.0006992020; DOI: 10.34067/KID.0006992020
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like

Jump to section

  • Article
  • Figures & Data Supps
  • Info & Metrics
  • View PDF

More in this TOC Section

  • Recovery and Mortality in Hepatorenal Syndrome
  • 4-methylumbelliferone in diabetic kidney disease
  • Patient and health system barriers to vascular access care
Show more Original Investigation

Cited By...

  • No citing articles found.
  • Google Scholar

Similar Articles

Related Articles

  • Google Scholar

Keywords

  • COVID-19
  • SARS-CoV-2
  • kidney
  • Histology
  • Immunostaining
  • in situ Hybridization

Articles

  • Current Issue
  • Early Access
  • Subject Collections
  • Article Archive
  • ASN Meeting Abstracts

Information for Authors

  • Submit a Manuscript
  • Author Resources
  • ASN Journal Policies
  • Reuse/Reprint Policy

About

  • Kidney360
  • ASN
  • ASN Journals
  • ASN Kidney News

Journal Information

  • About Kidney360
  • Kidney360 Email Alerts
  • Kidney360 Podcasts
  • Kidney360 RSS Feeds
  • Editorial Board

More Information

  • Advertise
  • ASN Podcasts
  • ASN Publications
  • Become an ASN Member
  • Disqus Code of Conduct
  • Disqus Information
  • Feedback
  • Follow on Twitter
  • Subscribe to JASN and CJASN

© 2021 American Society of Nephrology

Online ISSN - 2641-7650

Powered by HighWire