COVID-19–Related Collapsing Glomerulopathy in a Kidney Transplant Recipient

• DOI: 10.1053/j.ajkd.2020.06.009
• Publication Date: 2020-07-12T14:00:17Z
• Authors: Hélène Lazareth; Hélène Péré; Yannick Binois; Melchior Chabannes; Juliet Schurder; Thomas Bruneau; Alexandre Karras; Eric Thervet; Marion Rabant; David Veyer; Nicolas Pallet
• Keywords: Glomerulopathy

We report a case of kidney transplant recipient who presented with acute injury and nephrotic-range proteinuria in context severe respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Kidney biopsy revealed collapsing glomerulopathy. Droplet-based digital polymerase chain reaction did not detect the presence SARS-CoV-2 RNA fragment, virus was barely detectable plasma at time biopsy. RNAemia peaked several days later, followed by seroconversion despite absence circulating CD19-positive lymphocytes admission due to rituximab-based treatment antibody-mediated rejection 3 months earlier. Genotyping for risk alleles apolipoprotein L1 (APOL1) gene that donor carried low-risk G0/G2 genotype. This illustrates disease 2019 infection may promote glomerulopathy allografts APOL1 genotype podocyte precede RNAemia.