The DOI matches its Crossref record; 13 of the 13 references it cites were found in a registry or an index.
Renal histopathological analysis of 26 postmortem findings of patients with COVID-19 in China
Open accessAbstract
Although the respiratory and immune systems are the major targets of Coronavirus Disease 2019 (COVID-19), acute kidney injury and proteinuria have also been observed. Currently, detailed pathologic examination of kidney damage in critically ill patients with COVID-19 has been lacking. To help define this we analyzed kidney abnormalities in 26 autopsies of patients with COVID-19 by light microscopy, ultrastructural observation and immunostaining. Patients were on average 69 years (19 male and 7 female) with respiratory failure associated with multiple organ dysfunction syndrome as the cause of death. Nine of the 26 showed clinical signs of kidney injury that included increased serum creatinine and/or new-onset proteinuria. By light microscopy, diffuse proximal tubule injury with the loss of brush border, non-isometric vacuolar degeneration, and even frank necrosis was observed. Occasional hemosiderin granules and pigmented casts were identified. There were prominent erythrocyte aggregates obstructing the lumen of capillaries without platelet or fibrinoid material. Evidence of vasculitis, interstitial inflammation or hemorrhage was absent. Electron microscopic examination showed clusters of coronavirus-like particles with distinctive spikes in the tubular epithelium and podocytes. Furthermore, the receptor of SARS-CoV-2, ACE2 was found to be upregulated in patients with COVID-19, and immunostaining with SARS-CoV nucleoprotein antibody was positive in tubules. In addition to the direct virulence of SARS-CoV-2, factors contributing to acute kidney injury included systemic hypoxia, abnormal coagulation, and possible drug or hyperventilation-relevant rhabdomyolysis. Thus, our studies provide direct evidence of the invasion of SARSCoV-2 into kidney tissue. These findings will greatly add to the current understanding of SARS-CoV-2 infection.
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Cites
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The ACE2/angiotensin-(1-7)/MAS Axis of the renin-angiotensin system: focus on angiotensin-(1-7)
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Cited by
Nalbandian, A., Sehgal, K., Gupta, A., Madhavan, M. V., McGroder, C., Stevens, J. S., Cook, J. R., Nordvig, A. S., Shalev, D., Sehrawat, T. S., et al. (2021) · Nature Medicine · doi:10.1038/s41591-021-01283-z · Cited by 4,862
Extrapulmonary manifestations of COVID-19
Gupta, A., Madhavan, M. V., Sehgal, K., Nair, N., Mahajan, S., Sehrawat, T. S., Bikdeli, B., Ahluwalia, N., Ausiello, J. C., Wan, E. Y., et al. (2020) · Nature Medicine · doi:10.1038/s41591-020-0968-3 · Cited by 3,185
Multiorgan and Renal Tropism of SARS-CoV-2
Puelles, V. G., Lütgehetmann, M., Lindenmeyer, M. T., Sperhake, J. P., Wong, M. N., Allweiss, L., Chilla, S., Heinemann, A., Wanner, N., Liu, S., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmc2011400 · Cited by 1,775
Acute kidney injury in patients hospitalized with COVID-19
Hirsch, J. S., Ng, J. H., Ross, D. W., Sharma, P., Shah, H. H., Barnett, R. L., Hazzan, A. D., Fishbane, S., Jhaveri, K. D., Abate, M., et al. (2020) · Kidney International · doi:10.1016/j.kint.2020.05.006 · Cited by 1,523
Bourgonje, A. R., Abdulle, A. E., Timens, W., Hillebrands, J., Navis, G. J., Gordijn, S. J., Bolling, M. C., Dijkstra, G., Voors, A. A., Osterhaus, A. D., et al. (2020) · The Journal of Pathology · doi:10.1002/path.5471 · Cited by 1,081
Metadata
- Authors
- Su, H., Yang, M., Wan, C., Yi, L.-X., Tang, F., Zhu, H.-Y., Yi, F., Yang, H.-C., Fogo, A. B., Nie, X., & Zhang, C.
- Venue
- Kidney International
- Publisher
- Elsevier BV
- Published
- 2020-07
- Volume
- 98
- Issue
- 1
- Pages
- 219-227
- ISSN
- 0085-2538 (ISSN-L)
- OpenAlex
- W3015539298
- Cited by
- 1,755
- References
- 13
- FWCI
- 47.77
- Type
- journal article
- Language
- en
- Open access
- hybrid
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- Su, H., Yang, M., Wan, C., Yi, L.-X., Tang, F., Zhu, H.-Y., Yi, F., Yang, H.-C., Fogo, A. B., Nie, X., & Zhang, C. (2020). Renal histopathological analysis of 26 postmortem findings of patients with COVID-19 in China. Kidney International. https://doi.org/10.1016/j.kint.2020.04.003
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