Evidence map›Paper›PMID 32327202›Full record

ArticleKidney international2020

Renal histopathological analysis of 26 postmortem findings of patients with COVID-19 in China.

Hua Su, Ming Yang, Cheng Wan, Li-Xia Yi, Fang Tang, Hong-Yan Zhu, Fan Yi, Hai-Chun Yang, Agnes B Fogo, Xiu Nie and 1 more

2 registry-linked trialsOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Kidney international, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 1,053 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1,053citing papers in PubMed, 4 pooled it
336.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04530448 phase4terminatednot on this map

Coronavirus Induced Acute Kidney Injury: Prevention Using Urine Alkalinization

TypeinterventionalSponsorWest Virginia UniversityRan2020 to 2021Enrolled3ConditionsCOVID, Coronavirus, Coronavirus Infection, AKIArmsSodium bicarbonate, Standard of Care
NCT04705766 recruitingnot on this mapstarted 2021, after this paper: background citation

The KIDCOV Study: ASSESSMENT of SARS-CoV-2 Without HOSPITALIZATION as a RISK FACTOR for ACUTE KIDNEY INJURY

Typeobservational_patient_registrySponsorUniversity of California, San FranciscoRan2021 to 2027Enrolled2,000ConditionsSARS-CoV Infection, Covid19, Corona Virus Infection, Acute Kidney InjuryArmsUrine Collection
3 · Its place in the literature

Who cites it

1,053 citing papers in PubMed, 4 syntheses or guidelines pooled it, 1,803 citations in OpenAlex.

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  10. Evaluation of muscle strength and renal function in survivors of severe COVID-19: A 12-month follow-up study.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2026
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993 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 2 countries.

Hua SuDepartment of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Ming YangDepartment of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Cheng WanDepartment of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Li-Xia YiDepartment of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Fang TangDepartment of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Hong-Yan ZhuDepartment of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Fan YiThe Key Laboratory of Infection and Immunity of Shandong Province, Department of Pharmacology, School of Basic Medical Sciences, Shandong University, Jinan, China.
Hai-Chun YangDepartment of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Agnes B FogoDepartment of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Xiu NieDepartment of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address: niexiuyishi@126.com.
Chun ZhangDepartment of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address: drzhangchun@hust.edu.cn.
Huazhong University of Science and Technology · CNUnion Hospital · CNVanderbilt University Medical Center · USShandong University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Although the respiratory and immune systems are the major targets of Coronavirus Disease 2019 (COVID-19), acute kidney injury and proteinuria have also been observed. Currently, detailed pathologic examination of kidney damage in critically ill patients with COVID-19 has been lacking. To help define this we analyzed kidney abnormalities in 26 autopsies of patients with COVID-19 by light microscopy, ultrastructural observation and immunostaining. Patients were on average 69 years (19 male and 7 female) with respiratory failure associated with multiple organ dysfunction syndrome as the cause of death. Nine of the 26 showed clinical signs of kidney injury that included increased serum creatinine and/or new-onset proteinuria. By light microscopy, diffuse proximal tubule injury with the loss of brush border, non-isometric vacuolar degeneration, and even frank necrosis was observed. Occasional hemosiderin granules and pigmented casts were identified. There were prominent erythrocyte aggregates obstructing the lumen of capillaries without platelet or fibrinoid material. Evidence of vasculitis, interstitial inflammation or hemorrhage was absent. Electron microscopic examination showed clusters of coronavirus-like particles with distinctive spikes in the tubular epithelium and podocytes. Furthermore, the receptor of SARS-CoV-2, ACE2 was found to be upregulated in patients with COVID-19, and immunostaining with SARS-CoV nucleoprotein antibody was positive in tubules. In addition to the direct virulence of SARS-CoV-2, factors contributing to acute kidney injury included systemic hypoxia, abnormal coagulation, and possible drug or hyperventilation-relevant rhabdomyolysis. Thus, our studies provide direct evidence of the invasion of SARSCoV-2 into kidney tissue. These findings will greatly add to the current understanding of SARS-CoV-2 infection.

Indexed as

AdultAgedAged, 80 and overChinaCoronavirus InfectionsCOVID-19FemaleHumansKidneyMaleMiddle AgedPandemicsPneumonia, Viralacute kidney injuryCOVID-19proteinuriarenal pathologySARS-CoV-2

Identifiers

PMID32327202
PMCPMC7194105
OpenAlexW3015539298

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.