Systematic Reviews
Copyright ©The Author(s) 2021.
World J Transplant. Nov 18, 2021; 11(11): 480-502
Published online Nov 18, 2021. doi: 10.5500/wjt.v11.i11.480
Table 1 Native kidney biopsy outcomes of collapsing glomerulopathy in coronavirus disease 2019 cases
Renal Px
Baseline creatinine (mg/dL)
Presentation creatinine (mg/dL)
Presentation proteinuria (g/day)
Presentation albumin (g/L)
Treatment received
Outcome (renal and survival)
RRT needed
Time to biopsy
Kudose et al[13] 46MBObesityAKI, NS1.< 10
Kudose et al[13]62MBHTN, prostate cancer, CKDAKI, NS210.712.13.1NoneDINo-< 10
Kudose et al[13]62MBHTN, DM, prostate CancerAKI, NRP111.6192.4HCQ, SteroidsDINo--
Kudose et al[13]57MBHTN, hepatitis C, CKDAKI, NRP1.< 10
Kudose et al[13]61MBHTN, obesityAKI, NRPNormal1592.5-DDYes--
Sharma et al[14] 77FBHTNAKI18.151.5-HCQ, SteroidsDIYes-No
Wu et al[16] 63MBHTN, DM-1.34.912.7--DDYes-< 10
Wu et al[16]64FBHTN, DM-
Wu et al[16] 65FBHTN, DM-1.32.913.6--DiedYes-Negative
Wu et al[16]44MB--1.411.425--DDYes-50-100
Wu et al[16] 37MB--19---DiedYes-< 10
Wu et al[16]56MBHTN-> 100
Akilesh et al[17]46MBHTNAKI, NS-8.713.7--DDYes2 wkNo
Akilesh et al[17]60FBHTNAKI, NRP-5.721----4 wkNo
Akilesh et al[17]58FBHTNAKI, NS-10.220--DDYes--
Akilesh et al[17]44MH-AKI, NRP-1211.4--DDYes6 wkNo
Akilesh et al[17]58MB-AKI, NRP-11.34--DIYesDay 4Yes
Akilesh et al[17]47MBHTNAKI, TMA-6.67.6--DDYesDay 25Yes
Akilesh et al[17]63FBHTNAKI, NRP, TMA -620--DDYesDay 10-14Yes
Gupta et al[18] 71MIHTN, DMAKI, NS1.194.4918.462Steroid (Prednisolone 60mg OD)DDYes1st-D6, 2nd 2 moNo
Gupta et al[18]54MBHTN, DMAKI, NS1.084.67161.6None-NoDay 30No
Noble et al[43]54MBHTN, obesityAKI, NRP1256.544.08-NoneDIYesDay 16Yes
Kissling et al[19]63MBHTN AKI, NRP-1.25-NoneDINoDay 8-
Magoon et al[21]28MB-AKI-0.992-NoneDIYesDay 7-34Yes
Magoon et al[21] 56MBHTN, CKDAKI, NRP-3.1721-NoneDIYes-Yes
Gaillard et al[20]79MBHTN, MGUS, CKDAKI, NRP-2.5511.42.9Dexamethasone, lopinavir/ritonavir, PLEXDDYesDay 5No
Sharma et al[15] 67MBHTN, DMAKI, NRP12.23.2-HCQ/steroidsDDYesDay 8-8/52< 10
Sharma et al[15] 49MBHTNAKI0.954.852.59-HCQ/steroidsDDYes> Day 4< 10
Nlandu et al[22]48MBHTN, DMAKI, NS0.7215.9 18-Chloroquine, azithromycin, vitamin CDIYesDay 30No
Deshmukh et al[23]42MI-NS-18'hypoalbuminaemia' notedRamipril -NoDay 24Yes
Kadosh et al[24] 56MBCKDAKI, NRP-1.86 (peak 7.78)1.97 (peak 7.35)-MMF and steroids stopped, azithromycin, nitozaxonideDINo> Day 7-
Coutourier et al[25] 53MBHTN AKI, NRP1.021.89 (peak 2.20)5.64 (peak 18.7)1.3 (day 3)Oseltamivir, HCQ, chloroquine, azithromycinDINoDay 3-11No
Couturier et al[25] 53MBHTN, Hepatitis BAKI, NRP1.355.34 (peak 6.01)1.5 (peak 2.65)---No> Day 7No
Larsen et al[26] 44MBHTN, DM, CKDAKI, NRP 1.443.9 (peak 25)2.5NoneDDYesDay 8Yes
Malhotra et al[27]64MBHTN, DM, CKD, HIV on HAARTAKI, NRP-2.32.74-Solumedrol, zinc, Vitamin C, Oxitris FilterDDYesDay 11Yes
Izzedine et al[28]49FBCKD, heart transplant, type 2 diabetes, HTN, obesityAKI, NS1.782.396.61.7-DIYesDay 8< 10
Izzedine et al[28]38FBCKD, SLE, HTN, obesityAKI, NS14.6411.7-1.9-DINo-< 10
Laboux et al[29]47MBHTNAKI0.830.31.22.5DialysisDIYesDay 30-
Malik et al[30]57MB-AKI, NS-2.0 then 3.414.93.4Antibiotics, oseltamivir, oxygenDDYes--
FSGS with podocytopathy
Akilesh et al[17] 59MBHTN, DMAKI, NRP-11.9> 12-Unknown-UnknownDay 11-
Table 2 Native kidney biopsy outcomes of acute tubular injury and necrosis in coronavirus disease 2019 cases
Renal presentation
Baseline creatinine (mg/dL)
Presentation Creatinine (mg/dL)
Presentation proteinuria (g/day)
Presentation albumin (g/L)
Treatment received
Outcome (renal and survival)
RRT needed
Time to biopsy
Sharma et al[14]62MHispanicT2DMAKI and proteinuria-1.23 -Steroid, HCQ, anakinra, plasmaDiedYes-Yes
Sharma et al[14] 69MHispanicHTNAKI, proteinuria, anti-cardiolipin positive-0.92.4-Steroid, HCQ, anakinra, plasmaDiedYes-Yes
Sharma et al[14]76FCaucasianT2DM, HTN Severe AKI and Proteinuria-1 (peak 4.4)0.9 -NoneDINo-No
Sharma et al[14]59MBlack HTN, CCFAKI, Proteinuria and raised K:L ratio-4.5 (peak 6)2.8-NoneDINo-Yes
Sharma et al[14]69FBlackHTN, HyperlipidaemiaAKI NRP-1.97.6-SteroidsDDYes-No
Kudose et al[13] 43FBlackT2DM, HLD, streptococcal infection, obesity (BMI 52.5)AKI-3.5 (peak 6.7)1-NoneDDYes-Yes
Kudose et al[13] 67MCaucasianHTN, Gout, ObeseAKI on CKD - 5.7 0.3 -Tocilizumab, HCQ, azithromycinDDYes-Yes
Kudose et al[13] 51MBlack HTN, AF, HLD, CVA, BPH AKI on CKD -Yes
Akilesh et al[17] 34FCaucasianHTN, T2DMAKI NS -1.2 7--DINoDay 4No
Akilesh et al[17] 67FHispanic HTNAKI-1.41--DINoDay 5Yes
Lenti et al[31]25MCaucasian-AKI NS -3.80.48------
Rossi et al[32] 49MCaucasianObesity AKI----HCQ, Lopinavir/RitonavirDIRequired when in hospital--
Papadimitriou et al[33]52M-HIV, HTN, coronary artery disease, Factor V deficiencyAKINormal7.51.85--DDYesDay 10-
Papadimitriou et al[33]64M-AF, hyperlipidaemia, goutAKI11.4--I&V, IV heparin then apixaban (AF), 4 units blood following haematemesis, meropenem (E. coli in sputum), RRT day 22 to 33, MRSA > linezolidDIYesDay 84-
Table 3 Transplant kidney biopsy findings in coronavirus disease 2019 cases
Renal Presentation
Baseline creatinine (mg/dL)
Presentation creatinine (mg/dL)
Presentation proteinuria (g/day)
Presentation albumin (g/L)
Treatment received
Outcome (renal and survival)
RRT needed
Time to biopsy
T-cell mediated rejection
Kudose et al[13] 54FCaucasianIgA Nephropathy, Donor Specific Ab +ve, HTN, obesityAKI1.72.60.2-Steroids, Tocilizumab, thymoglobulin, IVIGDINo -Yes
Akilesh et al[17] 47FBlackHIV-associated Nephropathy, Deceased Donor Tx 2015, Vascular Rejection Post-Tx, HTNAKI-1.632-Renal transplantation, 5-MTP, PLEX IVIG --6 wkNo
Akilesh et al[17] 54MAsian Chronic Transplant Glomerulopathy, C4d –ve, HTN, T2DM AKI with Proteinuria 1.95.2 3-Regular MMF withheld, regular tacrolimus dose reduced, steroids DINo6 wkNo
Abuzeineh et al[44]54MBlackDiabetic nephropathy, Tx, HTNAKI1.42.6--IVF, MMF discontinued, NHF oxygen, antibiotics, antifungals, tocilizumabDINo73 d-
Acute tubular injury
Akilesh et al[17] 42MHispanic Live Donor Tx 2019, HTN AKI1.271.530.15--DINo7 wkNo
Kudose et al[13] 54FHispanic ADPKD, Deceased Donor Tx 2020, HTNAKI
Westhoff et al[50]69M-Diabetic nephropathyAKI1.12.2--IV hydrocortisone, tacrolimus and MMF held, HCQ, levetiracetamDINo14 d-
Doevelaar et al[45]35MBlack Deceased donor Tx 2019AKI, Normothermic Regional Perfusion -1.73.29-Steroids (Hydrocortisone 200 mg/d)DINo 34 d -
Oniszczuk et al[48] 49MBlack Renovascular disease, deceased donor Tx 2020AKI, Nephrotic Syndrome 1.472.173.272.7Steroids, ACE Inhibitor DINo 2 wk-
Yamada et al[51] 49FBlack Pre-eclampsia, Live donor Tx 1995 (from sibling) AKI, Normothermic Regional Perfusion 1.6 3.4 6.3 3.8 at diagnosis with COVID-19 ACE Inhibitor, Steroids (Prednisolone 60 mg with quick wean due to side effects)DINo 5 d -
Collapsing FSGS
Noble et al[43] 45MBlackMalignant HTN, Obesity (BMI 42.6), Live Donor Tx 2016AKI, Nephrotic syndrome 3.224.691.09-MMR withheld on admission, restarted after 14 d. Steroid (Prednisolone dose doubled from 10 mg OD to 20mg OD)DD Yes12 dYes
Lazareth et al[47]29MBlackUrinary Schistosomiasis, Deceased Donor Tx 2015, Previous ABMR in Jan 2020AKI, Nephrotic Syndrome withheld temporarily DINo 2 d-
Transplant infarction
Kudose et al[13] 22MBlackMembranous Nephropathy PLA2R +ve, Deceased Donor Tx 2018, HTNAKI-9.4--Tocilizumab, HCQ, Azithromycin DDYes--
Webb et al[49]49M-Chronic glomerulonephritis, HTN, DCD renal transplant 2001 with subsequent ABMR, CMVAKI02.03--Nasal high flow oxygen, prednisolone, enoxaparin, ertapenemDDYes27 d-
Jespersen et al[46]49F-FSGSAKI-2.81--SupportiveDINo> 22 d-
Table 4 Post-mortem kidney biopsy findings in coronavirus disease 2019 cases
Number in series
Number with kidney histology
Age-median (range)
Gender (male), n (%)
Comorbidities, n (%)
AKI, n (%)
RRT, n (%)
Covid treatment, n (%)
Pathological findings, n (%)
Bradley et al[52]141473.5 (42-84)6Diabetes 5, HTN 9, CKD 56 (1 at presentation)-ATI 11, FSGS 1, chronic inflammation 1, renal vein thrombus 1
Su et al[67]262669 (39-87)19Diabetes 3, HTN 11, CKD 2-5 (6 no record)Arbidol 10, Ribavirin 2, Lopinavir/ritonavir 5, steroids 15ATI 26, TMA 1, FSGS 2, pigment nephropathy 3, IgA 1, pyelonephritis 2, PIGN 1
Santoriello et al[64]4231 (11 excluded due to autolysis)71.5 (38-97)29Diabetes 17, HTN 30, CKD 831 (94)-stage (38.1)8 (36)Plaquenil 36, steroids 22 (61% combination), tocilizumab 6 (17%)ATI 31, TMA 6, collapsing FSGS 1, chronic inflammation 27, IgA 1
Farkash et al[55]1153--11HCQ, IL-6 blinded trialATI 1
Werion et al[68]49664 (54-74)34Diabetes 10, HTN 23, CKD 711 (22)2 (4)HCQ 48 (98%), azi 7 (14%), steroids 7 14%), IL-7: 8 (16.5%), tocilizumab 1 (2%)ATI 5, FSGS 1, chronic inflammation 2
Lax et al[60]1111N/A8Diabetes 5, HTN 86 (54.5)-Azi/HCQ 2ATI 11, chronic inflammation 2
Golmai et al[56]121275 (49-92)10Diabetes 4, HTN 9, CKD 198Tocilizumab/HCQ/steroids 7, HCQ/steroids 4ATI 9, oxalosis 1
Falasca et al[54]18976.5 (27-92)12Diabetes 4, HTN 4 , CKD 2--Chronic inflammation 12
Schurink et al[65]212168 (41-78)16Diabetes 115 (71); 10 stage 35Chloroquine 10 (48%), antiviral 4 (19%), steroids 5 (24%)ATI 12, TMA 1
Hanley et al[58]10973 (IQR 52-79)7HTN 4---ATI 9, TMA 5
Rapkiewicz et al[62]7760 (44-65)3Diabetes 5, HTN 6, CKD 1--Azi/HCQ 2, Azi/HCQ/Tocilizumab 2, Azi/HCQ/AnakinraATI 7, TMA 1
González Pessolani et al[57]42782Diabetes 1, HTN 12-ATI 2, TMA 1
Jacobs et al[59]11781HTN 111Azi/HCQ/steroidsATI 1, Oxalosis 1
Sekulic et al[66]22(54-81)2Diabetes 2, HTN 2, CKD 12-Remdesivir 1ATI 2
Remmelink et al[63]171772 (62-77)12Diabetes 9, HTN 10, CKD 315-HCQ 15, Steroids 2, Lopinavir/ritonavir 2, Remdesivir 2, Oseltamivir 1-
Brook et al[53]5375 (58-82)1Diabetes 2, HTN 3, CKD 1---ATI 3
Menter et al[61]211776 (53-96)17Diabetes 7, HTN 21, CKD 4---ATI 14, TMA 2