Published online Nov 18, 2021. doi: 10.5500/wjt.v11.i11.480
Peer-review started: March 31, 2021
First decision: July 29, 2021
Revised: August 5, 2021
Accepted: October 31, 2021
Article in press: October 31, 2021
Published online: November 18, 2021
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can result in clinically significant multi-system disease, including involvement in the kidney. A wide range of histopathological findings have been reported in kidney biopsies in association with coronavirus disease 2019 (COVID-19) infection.
Renal dysfunction in COVID-19 infection is reported in association with multiple pathologies. However, the mechanism behind these pathologies is not well under
This systematic review was conducted to provide an overview of the current literature on the renal histopathological features and mechanistic insights described in asso
A systematic review was performed by conducting a literature search in the following websites-‘PubMed’, ‘Web of Science’, ‘Embase’ and ‘Medline-ProQuest’ with the following search terms- “COVID-19 AND kidney biopsy”, “COVID-19 AND renal biopsy”, “SARS-CoV-2 AND kidney biopsy” and “SARS-CoV-2 AND renal biopsy”. Data on presentation, histological features, management and outcome was extracted from the reported studies.
Our review identified a total of 59 studies reporting COVID-19 related histopathological diagnoses from kidney biopsy. Of these 59 studies, 30 reported on native kidney biopsies, nine reported on transplant biopsies, three reported on a mixture of native and transplant kidney biopsies and 17 reported on postmortem kidney biopsies. In total, there were 84 native biopsies, 15 transplant biopsies, and 189 postmortem biopsies. Many histopathological features were described, including acute tubular injury (ATI), collapsing focal segmental glomerular sclerosis, thrombotic microangiopathy and vasculitis.
Many other histopathological processes were observed in association with COVID-19 in addition to the expected ATI, highlighting the need for an early kidney biopsy.
Whilst the underlying pathological processes of a few conditions developing due to COVID-19 infection can be hypothesized based on our current understanding of kidney disease, further work is required to determine what, if any, is the link between COVID-19 and some of the other processes described.