Evidence map›Paper›PMID 32371536›Full record

ArticleJournal of the American Society of Nephrology : JASN2020

Ultrastructural Evidence for Direct Renal Infection with SARS-CoV-2.

Evan A Farkash, Allecia M Wilson, Jeffrey M Jentzen

Erratum issuedOpen access · greenAbstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Society of Nephrology : JASN, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 228 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
228citing papers in PubMed, 8 pooled it
8.7field-weighted citation impact, top 2% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

228 citing papers in PubMed, 8 syntheses or guidelines pooled it, 367 citations in OpenAlex.

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  13. Kidney involvement and anemia in COVID-19 infection.World journal of nephrology · 2025
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168 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

Evan A FarkashDepartment of Pathology, University of Michigan Medical School, Ann Arbor, Michigan efarkash@med.umich.edu.
Allecia M WilsonDepartment of Pathology, University of Michigan Medical School, Ann Arbor, Michigan.
Jeffrey M JentzenDepartment of Pathology, University of Michigan Medical School, Ann Arbor, Michigan.
University of Michigan–Ann Arbor · USKing County Medical Examiner's Office · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA significant fraction of patients with coronavirus disease 2019 (COVID-19) display abnormalities in renal function. Retrospective studies of patients hospitalized with COVID-19 in Wuhan, China, report an incidence of 3%-7% progressing to ARF, a marker of poor prognosis. The cause of the renal failure in COVID-19 is unknown, but one hypothesized mechanism is direct renal infection by the causative virus, SARS-CoV-2.

methodsWe performed an autopsy on a single patient who died of COVID-19 after open repair of an aortic dissection, complicated by hypoxic respiratory failure and oliguric renal failure. We used light and electron microscopy to examine renal tissue for evidence of SARS-CoV-2 within renal cells.

resultsLight microscopy of proximal tubules showed geographic isometric vacuolization, corresponding to a focus of tubules with abundant intracellular viral arrays. Individual viruses averaged 76

conclusionsThe presence of viral particles in the renal tubular epithelium that were morphologically identical to SARS-CoV-2, and with viral arrays and other features of virus assembly, provide evidence of a productive direct infection of the kidney by SARS-CoV-2. This finding offers confirmatory evidence that direct renal infection occurs in the setting of AKI in COVID-19. However, the frequency and clinical significance of direct infection in COVID-19 is unclear. Tubular isometric vacuolization observed with light microscopy, which correlates with double-membrane vesicles containing vacuoles observed with electronic microscopy, may be a useful histologic marker for active SARS-CoV-2 infection in kidney biopsy or autopsy specimens.

Indexed as

Acute Kidney InjuryAortic DissectionAutopsyBetacoronavirusCoronavirus InfectionsCOVID-19Epithelial CellsHumansKidney TubulesMaleMiddle AgedNephritisPandemicsPneumonia, ViralPrognosisRespiratory Insufficiencyacute kidney failureautopsyCOVID-19electron microscopyrenal pathologySARS-CoV-2

Identifiers

PMID32371536
PMCPMC7460898
OpenAlexW3022269241

What OpenQuestion holds

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Registered trials

None linked

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.