Frontiers in Medicine (Oct 2020)

Brazilian Consortium for the Study on Renal Diseases Associated With COVID-19: A Multicentric Effort to Understand SARS-CoV-2-Related Nephropathy

  • Antonio Augusto Lima Teixeira Júnior,
  • Antonio Augusto Lima Teixeira Júnior,
  • Antonio Augusto Lima Teixeira Júnior,
  • Precil Diego Miranda de Menezes Neves,
  • Precil Diego Miranda de Menezes Neves,
  • Precil Diego Miranda de Menezes Neves,
  • Joyce Santos Lages,
  • Kaile de Araújo Cunha,
  • Kaile de Araújo Cunha,
  • Monique Pereira Rêgo Muniz,
  • Monique Pereira Rêgo Muniz,
  • Dyego José de Araújo Brito,
  • Dyego José de Araújo Brito,
  • Andréia Watanabe,
  • Andréia Watanabe,
  • Elieser Hitoshi Watanabe,
  • Elieser Hitoshi Watanabe,
  • Luiz Fernando Onuchic,
  • Luiz Fernando Onuchic,
  • Lucas Lobato Acatauassu Nunes,
  • Antônio Fernando Coutinho Filho,
  • Flávia Lara Barcelos,
  • Giuseppe Cesare Gatto,
  • Antonio Monteiro,
  • Diego do Amaral Polido,
  • Douglas Rafanelle Moura de Santana Motta,
  • Thaísa de Oliveira Leite,
  • Felipe Leite Guedes,
  • Orlando Vieira Gomes,
  • Lucila Maria Valente,
  • Karla Cristina Silva Petruccelli Israel,
  • Francisco Rasiah Ladchumananandasivam,
  • Lígia Cristina Lopes de Farias,
  • Igor Denizarde Bacelar Marques,
  • Gustavo Lemos Uliano,
  • Carlos Eduardo Campos Maramaldo,
  • Lídio Gonçalves Lima Neto,
  • Weverton Machado Luchi,
  • David Campos Wanderley,
  • Stanley de Almeida Araújo,
  • Natalino Salgado Filho,
  • Natalino Salgado Filho,
  • Gyl Eanes Barros Silva,
  • Gyl Eanes Barros Silva

DOI
https://doi.org/10.3389/fmed.2020.584235
Journal volume & issue
Vol. 7

Abstract

Read online

Kidney involvement appears to be frequent in coronavirus disease 2019 (COVID-19). Despite this, information concerning renal involvement in COVID-19 is still scarce. Several mechanisms appear to be involved in the complex relationship between the virus and the kidney. Also, different morphological patterns have been described in the kidneys of patients with COVID-19. For some authors, however, this association may be just a coincidence. To investigate this issue, we propose assessing renal morphology associated with COVID-19 at the renal pathology reference center of federal university hospitals in Brazil. Data will come from a consortium involving 17 federal university hospitals belonging to Empresa Brasileira de Serviços Hospitalares (EBSERH) network, as well as some state hospitals and an autopsy center. All biopsies will be sent to the referral center for renal pathology of the EBSERH network. The data will include patients who had coronavirus disease, both alive and deceased, with or without pre-existing kidney disease. Kidney biopsies will be analyzed by light, fluorescence, and electron microscopy. Furthermore, immunohistochemical (IHC) staining for various inflammatory cells (i.e., cells expressing CD3, CD20, CD4, CD8, CD138, CD68, and CD57) as well as angiotensin-converting enzyme 2 (ACE2) will be performed on paraffinized tissue sections. In addition to ultrastructural assays, in situ hybridization (ISH), IHC and reverse transcription-polymerase chain reaction (RT-PCR) will be used to detect Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) in renal tissue. For the patients diagnosed with Collapsing Glomerulopathy, peripheral blood will be collected for apolipoprotein L-1 (APOL1) genotyping. For patients with thrombotic microangiopathy, thrombospondin type 1 motif, member 13 (ADAMTS13), antiphospholipid, and complement panel will be performed. The setting of this study is Brazil, which is second behind the United States in highest confirmed cases and deaths. With this complete approach, we hope to help define the spectrum and impact, whether immediate or long-term, of kidney injury caused by SARS-CoV-2.

Keywords