Membranous nephropathy in a patient with COVID-19 infection

Guo, Weiwen; Tan, Puay Hoon; Baikunje, Shashidhar

doi:10.1007/s40620-021-01165-0

Cited by 8 publications

(20 citation statements)

References 9 publications

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“…In our study, NELL1-associated MN was found in the kidney, and the activated complement system in the liver exacerbated MN by MAC ( Cravedi, 2021 ). MN has rarely been reported in human COVID-19 infection ( Guo et al, 2022 ) or vaccination ( Aydin et al, 2021 ), with only a small fraction of these cases being PLA2R-positive. Hence, the observation of MN in our study provides new insights into SARS-CoV-2 infection-associated renal manifestations, although whether the MN in macaques is primary or secondary remains to be elucidated.…”

Section: Discussionmentioning

confidence: 99%

Single-nucleus transcriptomic profiling of multiple organs in a rhesus macaque model of SARS-CoV-2 infection

Wei-hua

Song

et al. 2022

Zoological Research

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Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes diverse clinical manifestations and tissue injuries in multiple organs. However, cellular and molecular understanding of SARS-CoV-2 infection-associated pathology and immune defense features in different organs remains incomplete. Here, we profiled approximately 77 000 single-nucleus transcriptomes of the lung, liver, kidney, and cerebral cortex in rhesus macaques ( Macaca mulatta ) infected with SARS-CoV-2 and healthy controls. Integrated analysis of the multi-organ dataset suggested that the liver harbored the strongest global transcriptional alterations. We observed prominent impairment in lung epithelial cells, especially in AT2 and ciliated cells, and evident signs of fibrosis in fibroblasts. These lung injury characteristics are similar to those reported in patients with coronavirus disease 2019 (COVID-19). Furthermore, we found suppressed MHC class I/II molecular activity in the lung, inflammatory response in the liver, and activation of the kynurenine pathway, which induced the development of an immunosuppressive microenvironment. Analysis of the kidney dataset highlighted tropism of tubule cells to SARS-CoV-2, and we found membranous nephropathy (an autoimmune disease) caused by podocyte dysregulation. In addition, we identified the pathological states of astrocytes and oligodendrocytes in the cerebral cortex, providing molecular insights into COVID-19-related neurological implications. Overall, our multi-organ single-nucleus transcriptomic survey of SARS-CoV-2-infected rhesus macaques broadens our understanding of disease features and antiviral immune defects caused by SARS-CoV-2 infection, which may facilitate the development of therapeutic interventions for COVID-19.

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Section: Discussionmentioning

confidence: 99%

Single-nucleus transcriptomic profiling of multiple organs in a rhesus macaque model of SARS-CoV-2 infection

Wei-hua

Song

et al. 2022

Zoological Research

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“…In total, five cases of MN associated with SARS-CoV-2 infection have been identified before 6 September 2022 in four articles [ 9 , 10 , 11 , 12 ] ( Table 1 )—all new, including one female and four males. Four elderly cases had a previous chronic medical history, especially hypertension.…”

Section: New-onset Mn Post Sars-cov-2 Infectionmentioning

confidence: 99%

“…All patients underwent kidney biopsy (phospholipase A2 receptor (PLA2R)—two positive, three negative; viral particles, all negative). Only one case [ 11 ] presented with PLA2R-Ab positive expression. The auxiliary examination of four cases suggested acute kidney injury (AKI) at admission.…”

Section: New-onset Mn Post Sars-cov-2 Infectionmentioning

confidence: 99%

“…Despite that, the albumin increased from 17 to 26 g/L, and serum creatinine decreased from 7.1 to 3.7 mg/dL with the treatment of lenzilumab and intravenous methylprednisolone. A young patient [ 11 ] initially received angiotensin-converting-enzyme inhibitor (ACEI), whereas there was no remission at 3 months, followed by CTX combined with prednisolone which achieved gradual remission within 2 months. One elderly male case [ 12 ] had been dependent on dialysis for 80 days.…”

Section: New-onset Mn Post Sars-cov-2 Infectionmentioning

confidence: 99%

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New-Onset and Relapsed Membranous Nephropathy post SARS-CoV-2 and COVID-19 Vaccination

2022

Viruses

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Since the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak and COVID-19 vaccination, new-onset and relapsed clinical cases of membranous nephropathy (MN) have been reported. However, their clinical characteristics and pathogenesis remained unclear. In this article, we collected five cases of MN associated with SARS-CoV-2 infection and 37 related to COVID-19 vaccination. Of these five cases, four (4/5, 80%) had acute kidney injury (AKI) at disease onset. Phospholipase A2 receptor (PLA2R) in kidney tissue was negative in three (3/5, 60%) patients, and no deposition of virus particles was measured among all patients. Conventional immunosuppressive drugs could induce disease remission. The underlying pathogenesis included the subepithelial deposition of viral antigens and aberrant immune response. New-onset and relapsed MN after COVID-19 vaccination generally occurred within two weeks after the second dose of vaccine. Almost 27% of patients (10/37) suffered from AKI. In total, 11 of 14 cases showed positive for PLA2R, and 20 of 26 (76.9%) presented with an elevated serum phospholipase A2 receptor antibody (PLA2R-Ab), in which 8 cases exceeded 50 RU/mL. Conventional immunosuppressive medications combined with rituximab were found more beneficial to disease remission for relapsed patients. In contrast, new-onset patients responded to conservative treatment. Overall, most patients (24/37, 64.9%) had a favorable prognosis. Cross immunity and enhanced immune response might contribute to explaining the mechanisms of MN post COVID-19 vaccination.

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“…Kudose et al detected MN in five (6.6%) of 76 infected patients, and PLA2R was positive in two of them ( 17 ). In one reported case, a patient presented MN PLA2R positive 4 weeks after diagnosis of mild COVID-19, with nephrotic syndrome, AKI and partial response to immunosuppressive treatment ( 19 ).…”

Section: Morphological Kidney Findings Associated With Covid-19 Infec...mentioning

confidence: 99%

Kidney injury associated with COVID-19 infection and vaccine: A narrative review

et al. 2022

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The respiratory tract is the main infection site for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), resulting in many admissions to intensive care centers in several countries. However, in addition to lung involvement, kidney injury caused by the novel coronavirus has proven to be a significant factor related to high morbidity and mortality, alarming experts worldwide. The number of deaths has drastically reduced with the advent of large-scale immunization, highlighting the importance of vaccination as the best way to combat the pandemic. Despite the undeniable efficacy of the vaccine, the renal side effects associated with its use deserve to be highlighted, especially the emergence or reactivation of glomerulopathies mentioned in some case reports. This study aimed to identify the main renal morphological findings correlated with COVID-19 infection and its vaccination, seeking to understand the pathophysiological mechanisms, main clinical features, and outcomes.

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Membranous nephropathy in a patient with COVID-19 infection

Cited by 8 publications

References 9 publications

Single-nucleus transcriptomic profiling of multiple organs in a rhesus macaque model of SARS-CoV-2 infection

Single-nucleus transcriptomic profiling of multiple organs in a rhesus macaque model of SARS-CoV-2 infection

New-Onset and Relapsed Membranous Nephropathy post SARS-CoV-2 and COVID-19 Vaccination

Kidney injury associated with COVID-19 infection and vaccine: A narrative review

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