COVID-19 Associated Illnesses From Alveoli to Glomeruli: A Case Report

Abstract

Hypoxemic respiratory failure is the most frequent complication of severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) infection. Coronavirus disease-19 (COVID-19) is no longer considered a standalone respiratory infection. It can involve other organs, including kidneys by direct invasion or indirectly through immune activation, cytokine storm, microthrombi and hemodynamic instability. Multiorgan involvement carries a worse prognosis in COVID-19. Tubulopathy is the most frequently reported renal pathology, followed by glomerulopathies. Among the glomerulopathies, immunoglobulin A (IgA) nephropathy is less often reported. Differentiating tubulopathy from glomerulopathy is important from the management and prognostic point of view. Laboratory investigations, including urine microscopy, cannot predict glomerulopathy as a cause of renal involvement. Therefore, it is important to proceed with renal biopsy early to make a definite diagnosis. We report a case of a 33-year-old male who presented three weeks after recovery from COVID-19 with proteinuric acute kidney injury. Subsequent renal biopsy revealed IgA nephropathy.

Relapses or de-novo IgA nephropathy following COVID-19 vaccination; a narrative review

“…IgAN following COVID-19 vaccination 3 based on immunofluorescence images, which were consistent with IgA nephropathy following recovery from COVID-19 infection. This patient recovered with furosemide and enalapril administration (10).…”

Extensive Palpable Purpura Preceding Renal Dysfunction in Immunoglobulin A Vasculitis Due to Coronavirus-19 Infection

“… 2 In addition to the reports of IgA vasculitis described above, there have also been reports of IgA nephropathy after COVID-19 infection. 7 , 8 Debate is ongoing as to whether IgA vasculitis and IgA nephropathy represent clinical manifestations on a continuous spectrum of one disease, with IgA vasculitis as the systemic form of IgA nephropathy. 9 …”

COVID-19 and Glomerular Diseases

“…Three patient were treated conservatively with RAAS inhibitor. 54 , 56 , 58 Of these, one had complete recovery of proteinuria and the other two had improvement in serum creatinine but the amount of proteinuria were not reported. 54 , 56 , 58 (Supplementary table 4).…”

“…Of these, 13 patients had clinical data available. 47 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 …”

“…Light microscopy shows moderate to diffuse cellular to fibrocellular crescents associated with ruptured Bowman’s capsule. 48 , 49 , 50 , 51 , 52 , 53 , 54 The degrees of glomerulosclerosis ranges from mild to severe. 72 ATI is common with inflammatory infiltrates in some cases, and tubulitis may be observed.…”