SARS-CoV-2 renal tropism associates with acute kidney injury

SARS-CoV-2-mediated acute kidney injury might be explained by indirect factors (eg, cytokine-mediated injury) and by direct viral infection and replication in kidney epithelial cells.4 We isolated SARS-CoV-2 from an autopsied kidney, which produced a 1000-times increase in viral RNA after 48 h of ce...

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Published in:The Lancet (British edition) Vol. 396; no. 10251; pp. 597 - 598
Main Authors: Braun, Fabian, Lütgehetmann, Marc, Pfefferle, Susanne, Wong, Milagros N, Carsten, Alexander, Lindenmeyer, Maja T, Nörz, Dominik, Heinrich, Fabian, Meißner, Kira, Wichmann, Dominic, Kluge, Stefan, Gross, Oliver, Pueschel, Klaus, Schröder, Ann S, Edler, Carolin, Aepfelbacher, Martin, Puelles, Victor G, Huber, Tobias B
Format: Journal Article
Language:English
Published: England Elsevier Ltd 29.08.2020
Elsevier Limited
Subjects:
Acute Kidney Injury - virology
Autopsies
Autopsy
Betacoronavirus
Coronavirus Infections - complications
Coronavirus Infections - virology
Coronaviruses
COVID-19
Cytokines
Epithelial cells
Humans
Immunofluorescence
Infections
Injuries
Kidneys
Pandemics
Pharmaceuticals
Pneumonia, Viral - complications
Pneumonia, Viral - virology
Prognosis
Replicase
Ribonucleic acid
RNA
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Tropism
Viral diseases
Viral infections
Viral Tropism
Viruses
ISSN:0140-6736, 1474-547X, 1474-547X
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Summary:SARS-CoV-2-mediated acute kidney injury might be explained by indirect factors (eg, cytokine-mediated injury) and by direct viral infection and replication in kidney epithelial cells.4 We isolated SARS-CoV-2 from an autopsied kidney, which produced a 1000-times increase in viral RNA after 48 h of cell infection in vitro (figure; appendix p 1), thus confirming the presence of infective virus in the kidney, even under post-mortem conditions. Furthermore, we found that patient-derived SARS-CoV-2 replicates in non-human primate kidney tubular epithelial cells (the main cellular target of acute kidney injury) using indirect immunofluorescence imaging of SARS-CoV-2 non-structural protein 3, one of the SARS-CoV replicase cleaving products (appendix p 5).5 Our findings indicate that SARS-CoV-2 renal tropism is associated with disease severity (ie, premature death) and development of acute kidney injury. TBH reports grants from the German Research Foundation (CRC/1192, HU 1016/8-2, HU 1016/11-1, HU 1016/12-1), the Federal Ministry of Education and Research (STOP-FSGS-01GM1518C), and the European Research Council (grant 616891) during the study; grants and personal fees from Fresenius Medical Care; grants from Amicus Therapeutics and Sanofi Genzyme; and personal fees from Boehringer Ingelheim, Goldfinch Bio, Novartis Pharma, DaVita Germany, and Bayer Vital, unrelated to this Correspondence.
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ISSN:0140-6736
1474-547X
1474-547X
DOI:10.1016/S0140-6736(20)31759-1