Table 4.
Pathology findings in kidney biopsies of patients with coronavirus disease 2019
| Pt. | Diagnosis, n (%) | Other Findings, n (%) | Clinically Relevant Data, n (%) | Light Microscopy | Immunohistochemistry | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| No. Glom | No. GS (% No. Glom) | No. SS (% No. Glom) | Fibrous Crescents (% No. Glom) | Cellular/Fresh Necrosis (% No. Glom) | ATI | IF/TA | AIF | AH | IgA | IgG | IgM | Fibrinogen | C3 | C1q | Myoglobin | ||||
| Necrotizing GN | |||||||||||||||||||
| C1–C3 | Pauci-immune GN: 3 (100) | — | HTN/DM II: 2 (67) | 10 (11–43) | 10 (6%–58%) | 5 (6%–45%) | 4 (0%–45%) | 3 (0%–100%) | 50% (30%–80%) | 40% (10%–60%) | 2 (1–3) | 2 (1–3) | 0 (0–0) | 0 (0–1) | 1 (1–2) | 0 (0–0) | 0 (0–1) | 1 (0–2) | 0 (0–0) |
| TMA | |||||||||||||||||||
| C4–C7a | TMA: 4 (100) | ATI: 2 (50) ATI, myoglobin cast nephropathy: 1 (25) |
HTN: 1 (25) | 9 (5–13) | 2 (0%–6%) | 1 (0%–18%) | 0 (0%) | 0 (0%) | 65% (40%–80%) | 18% (5%–40%) | 1 (0–1) | 0 (0–0) | 0 (0–1) | 0 (0–1) | 2 (1–2) | 0 (0–1) | 1 (0–1) | 2 (1–3) | 0 (0–1) |
| Podocytopathies | |||||||||||||||||||
| C8–C9 | Collapsing FSGS: 1 (50) Minimal change disease: 1 (50) |
ATI: 1 (50) IgA nephropathy: 1 (50) |
HTN/DM II: 1 (50) | 17 (12–22) | 6 (17%–45%) | 2 (0%–14%) | 0 (0%) | 0 (0%) | 43% (10%–75%) | 15% (5%–25%) | 2 (1–3) | 1 (0–1) | 1 (0–1) | 0 (0–0) | 2 (1–2) | 1 (0–1) | 0 (0–0) | 2 (1–2) | 0 (0–0) |
| ATI | |||||||||||||||||||
| C10–C14 | ATI: 5 (100) | FSGS (biopsy-proven in 1991): 1 (20) Myoglobin cast nephropathy: 1 (20) IN: 1 (20) |
HTN: 4 (80) | 7 (3–13) | 1 (0%–67%) | 1 (0%–67%) | 0 (0%) | 0 (0%) | 70% (30%–90%) | 24% (5%–60%) | 1 (0–3) | 1 (0–2) | 0 (0–0); N/A in one case | 0 (0–0); N/A in one case | 1 (0–2); N/A in one case | 0 (0–0); N/A in one case | 0 (0–1); N/A in one case | 1 (0–2); N/A in one case | 0 (0–1) |
| IN | |||||||||||||||||||
| C15 | IN | — | — | 14 | 4 (29%) | 0 (0%) | 0 (0%) | 0 (0%) | 15% | 70% | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | N/A |
Values are mean (range) or n (%). The immunohistology, arterial intimal fibrosis, and AH findings are presented using a semiqualitative scoring system, ranging between 0 and 3, with a higher score indicating a more extensive staining. Pt., patient; Glom, glomeruli; GS, global sclerosis; SS, segmental sclerosis; ATI, acute tubular injury; IF/TA, interstitial fibrosis and tubular atrophy; AIF, arterial intimal fibrosis; AH, arteriolar hyalinosis; IgA, immunoglobulin A; IgG, immunoglobulin G; IgM, immunoglobulin M; C3, complement C3; C1q, complement C1q; HTN, hypertension; DM, diabetes mellitus; DM II, type 2 DM; TMA, thrombotic microangiopathy; N/A, not assessable; IN, interstitial nephritis.
The information provided for case C7 has been published in part.8