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Clinical and morphological parallels of lung and kidney damage in COVID-19

https://doi.org/10.36485/1561-6274-2020-24-5-97-107

Abstract

This article reviews the available literature on the SARS-Cov-2 virus and its similarities with its predecessors. The mechanisms of infection due to the structure and epidemiology of the virus are described. Based on these data, the pathogenesis of COVID- 19 infection is described. Based on this, the authors suggest probable extrapulmonary target cells and target organs for the virus depending on their expression ofthe vector protein, APF-2. The article describes a classic clinical picture of the disease, possible complications of its course, and the extrapulmonary (cardiac, immunological, renal) manifestations ofthe infection. The authors traced and described the chain of knowledge about the involvement of the kidneys in the pathological process at COVID-19. Based on numerous studies, we are looking at the site of acute renal injury, coagulopathy, systemic inflammatory response in the spectrum of manifestations of COVID-19 relative to kidneys in patients with COVID-19, including those with hemodialysis. The article builds clinical-morphological associations between lung and kidney damage at COVID-19. We present new data on the pathomorphological manifestations of COVID-19 in the lungs, including own autopsy data. Specific
signs of the effects of the virus on alveolocytes and its cytopathic effect are highlighted and described. The article focuses on kidney signs of infection. The authors give new results of their own observations obtained during an autopsy of patients with COVID-19. Detailed morphological changes in kidney structures have been described, proving that the human kidney is a specific target for SARS-Cov-2 infection, and can also serve as a viral reservoir for the pathogen, playing a role in its subsequent persistence.

About the Authors

A. S. Litvinov
Limited liability Company "Agidel Medical center"; "Limited liability Partnership "Metaco LLP"
Russian Federation

Alexander S. Litvinov, MD, PhD

Leading Scientific Specialist, researcher; Deputy Medical Director. 

Affiliations: 450000, Ufa, st. Karl Marx, 48/2. Phone: (812)346- 39-26



A. V. Savin
YugEkoService Limited liability Company; "Limited Partnership "Harmony Medical Clinic"
Russian Federation

Alexander V. Savin, nephrologist

Leading Scientific Specialist, researcher. 

Affiliations: 344022, Rostov-on-Don, 170 Krasnoarmeyskayast., Phone: 89198963582



A. A. Kukhtina
Moscow state medical and dental University named after A. I. Evdokimov
Russian Federation

Alina A. Kukhtina, resident

Department of polyclinic therapy

Affiliations: 127473, Moscow, 20/1 Delegatskayast. Phone: 8(903)624-77-2



D. A. Sitovskaya
"Russian Research Neurosurgical Institute professor A. L. Polenov (a branch ofthe National Medical Research Center named V. A. Almazov); "City Mariinsky Hospital; St. Petersburg State Pediatric Medical University
Russian Federation

Daria A. Sitovskaya, researcher

Leading Scientific Specialist

Affiliations: 191014, St. Petersburg, 12 Mayakovskogost. Phone: 89817613197



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Review

For citations:


Litvinov A.S., Savin A.V., Kukhtina A.A., Sitovskaya D.A. Clinical and morphological parallels of lung and kidney damage in COVID-19. Nephrology (Saint-Petersburg). 2020;24(5):97-107. (In Russ.) https://doi.org/10.36485/1561-6274-2020-24-5-97-107

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ISSN 1561-6274 (Print)
ISSN 2541-9439 (Online)