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Kidney as target organ in COVID-19

Mechanism of kidney involvement not clear
Multiorgan failure and shock
Cytokine storm
Direct infection – tubular cells
COVID 19 binds to ACE2 receptor to enter cells
ACE2 abundant in podocytes and proximal tubular epithelial cells per single-cell RNAseq data reported by Xu et al (Preprint 2020)
Report from Wuhan 23/85 patients AKI (Human Kidney is a Target for Novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-Infection. Bo Diao, et al medRxiv 2020.03.04.20031120; doi:
Kidney tissues postmortem(n=6) severe ATN and lymphocyte infiltration. Immunohistochemistry showed that SARS-CoV-2 NP antigen accumulated in kidney tubules. Viral infection not only induces CD68+ macrophages infiltrated into tubulointerstitium, but also enhances complement C5b-9 deposition on tubules.