TABLE 4.
Kidney evidences described in COVID-19 death.
| Author(s) | Sample | Gross examination | Microscopic finding(s) | Immunoistochemistry | Post-mortem molecular test | Other(s) |
|---|---|---|---|---|---|---|
| Bradley et al. (2020) | 14 (7 M, 7 F; 42–84 years) | N.A. | Chronic interstitial inflammation, more prominent perivascular lymphocytic inflammation | SARS-CoV-2 (2/14 in renal tubular epithelial cells) | RT-PCR (positive) | TEM: Viral particles in endothelial cells (1/2), proximal tubular epithelial cells (1/2) |
| Sekulic et al. (2020) | 2 (2 M; 54 and 81 years) | N.A. | ATI | N.A. | RT-PCR (negative) | N.A. |
| Lacy et al. (2020) | 1 (F, 58 years) | Finely granular, focal cortical scars | Arteriolosclerosis, mesangial sclerosis, hypercellularity, focal global glomerulosclerosis | N.A. | N.A. | N.A. |
| Yan et al. (2020) | 1 (F, 44 years) | Unrelevant | Focal ATI with tubules flattened epithelium, lumens containing sloughed epithelial lining cells, granular casts, tamm-horsfall protein and intraluminal accumulation of cellular debris in focal areas | N.A. | N.A. | N.A. |
| Menter et al. (2020) | 21 (4 F; 17 M; 53–96 years) | Unrelevant | ATI (14/15), DIC (3/17), hypertensive nephropathy (2/17), Diabetic nephropathy (2/17) | N.A. | RT-qPCR (variable) | TEM: Prominent activation of podocytes, endothelial cells and proximal tubular epithelial cells; vesicles in podocytes cytoplasm with virus-like particles (2/2) |
| Lax et al. (2020) | 11 (8 M; 3 F; 66–91 years) | N.A. | Nodular glomerulosclerosis (4/11), benign nephrosclerosis (10/11), ATI with necrosis (11/11), chronic interstitial nephritis (2/11); cortical fibrosis (1/11) | N.A. | N.A. | N.A. |
| Oprinca and Muja (2020) | 3 (1 F 79 years; 1 F 27 years; 1 M 70 years) | Medullary congestion (2/3) | ATI, focal microthrombi in glomeruli (2/2) | N.A. | N.A. | N.A. |
| Remmelink et al. (2020) | 17 (12 M, 5 F; 62–77 years) | Enlarged with a pale cortex and petechial aspect | Hemosiderin renal tubules (9/17), pigmented renal casts (12/17) | N.A. | RT-PCR (positive 14/16) | N.A. |
| Nunes Duarte-Neto et al. (2020) | 10 (5 F; 5 M; 33–83 years) | N.A. (biopsy on 8/10) | Glomeruli shrinkage (8/8), fibrin thrombi (6/8), focal and mesangial matrix expanding (8/8), focal glomerular sclerosis (7/8), ATI (8/8), hyaline tubular casts (6/8), pigmented tubular casts (1/8), arteriolosclerosis (8/8) | N.A. | N.A. | N.A. |
| Hanley et al. (2020a) | 10 (7 M, 3 F; 73 years median age) | Unrelevant | ATI, glomerular microaneurysm and thrombi (1/9), rare thrombi in interlobular arteries | N.A. | RT-PCR (positive 3/4) | N.A. |
| Rapkiewicz et al. (2020) | 7 (4 F, 3 M; 44.65 years) | N.A. | Microthrombi in scattered peritubular capillaries and venules, ATI with necrosis, cellular casts, some pigmented red blood cell casts (7/7); thrombotic microangiopathy in glomeruli (1/7) | C4d (negative 2/2) | N.A. | TEM: Virions in proximal convoluted tubules, rare podocyte virions |
| Kudose et al. (2020) | 17 (5 F, 12 M; 22–72 years) | N.A. (biopsy) | ATI, collapsing glomerulopathy, membranous glomerulopathy | Sars-CoV-2 sP and NP (negative) | N.A. | TEM: Tubular reticular inclusion |
| Su et al. (2020) | 26 (7 F; 19 M; 39–87 years) | N.A. | ATI (26/26), multiple foci of bacteria (2/26), pigmented casts (3/26), arteriosclerosis (26/26), glomerular segmental fibrin thrombus with severe endothelial injury (3/26), focal segmental glomerulosclerosis (2/26) | CD3, CD4, CD8, CD20, CD21, CD31, CD61, CD68 (positive, 9/9), ACE2 (positive in proximal tubules, 3/5). IF: SARS-CoV-2 NP (3/6) | N.A. | TEM: Coronavirus-like particles (7/9), dense deposit (2/9), subendothelial expansion (5/9) |
| Santoriello et al. (2020) | 42 (29 M, 13 F; 38–97 years) | N.A. | ATI (19/32), focal fibrin thrombi in glomeruli or blood vessel (6/42) | N.A. | N.A. | TEM: Tubules degenerative changes with attenuation and loss of brush border, dilation of endoplasmic reticulum and intraluminal cellular debris. ISH: Negative |
N.A., not available; ATI, acute tubular injury; Sars-CoV-2 NP, Sars-CoV-2 nucleo-capsid protein; Sars-CoV-2 sP, Sars-CoV-2 spike protein; ACE2, angiotensin-converting enzyme 2; IF, immunofluorescence; TEM, transmission electron microscopy.