Vasculitis

Acute tubular necrosis

Glomerulonephritis

Infectious disease (medical specialty)

Disease

Glomerulopathy

Coronavirus disease 2019 (COVID-19)

Kidney

Acute kidney injury

Internal medicine

Pathology

Thrombotic microangiopathy

Autopsy

Renal pathology

Medicine

Clinical Kidney Journal

Acute kidney injury (AKI) is common among hospitalized patients with coronavirus disease 2019 (COVID-19), with the occurrence of AKI ranging from 0.5% to 80%. An improved knowledge of the pathology of AKI in COVID-19 is crucial to mitigate and manage AKI and to improve the survival of patients who develop AKI during COVID-19. In this review, we summarize the published cases and case series of various kidney pathologies seen with COVID-19. Both live kidney biopsies and autopsy series suggest acute tubular injury as the most commonly encountered pathology. Collapsing glomerulopathy and thrombotic microangiopathy are other encountered pathologies noted in both live and autopsy tissues. Other rare findings such as anti-neutrophil cytoplasmic antibody vasculitis, anti-glomerular basement membrane disease and podocytopathies have been reported. Although direct viral infection of the kidney is possible, it is certainly not a common or even widespread finding reported at the time of this writing (November 2020).

Pathology of COVID-19-associated acute kidney injury