Renal involvements in COVID-19

Abstract

COVID-19 is a disease related to an RNA virus, SARS-CoV-2, that affects the respiratory system with a great variability of expression. All the other systems can be affected. Renal involvement is common during COVID-19 and is associated with high morbidity and mortality. The exact mechanism is not well understood, but the virus could directly or indirectly affect the kidney. The common renal impairment is acute kidney injury (AKI) related to acute tubular necrosis (ATN). The other damages are mainly represented by proximal tubulopathy, and COVAN (COVID-19-associated nephropathy), occurring on a pathogenic variant of apolipoprotein L1 (APOL1), a thrombotic microangiopathy (TMA) by endothelial dysfunction and exacerbation or triggering a glomerular disease after vaccination against SARS-CoV-2. Renal involvement should be systematically sought in any patient hospitalized for COVID-19. Appropriate support and follow-up of COVID-19 patients with renal impairment are mandatory.