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Teixeira Júnior AAL, Neves PDMDM, Lages JS, Cunha KDA, Muniz MPR, Brito DJDA, Watanabe A, Watanabe EH, Onuchic LF, Nunes LLA, Coutinho Filho AF, Barcelos FL, Gatto GC, Monteiro A, Polido DDA, Motta DRMDS, Leite TDO, Guedes FL, Gomes OV, Valente LM, Israel KCSP, Ladchumananandasivam FR, de Farias LCL, Marques IDB, Uliano GL, Maramaldo CEC, Neto LGL, Luchi WM, Wanderley DC, Araújo SDA, Salgado Filho N, Silva GEB. Brazilian Consortium for the Study on Renal Diseases Associated With COVID-19: A Multicentric Effort to Understand SARS-CoV-2-Related Nephropathy. Front Med (Lausanne) 2020; 7:584235. [PMID: 33195337 PMCID: PMC7663765 DOI: 10.3389/fmed.2020.584235] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/08/2020] [Indexed: 01/08/2023] Open
Abstract
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.
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Affiliation(s)
- Antonio Augusto Lima Teixeira Júnior
- Postgraduate Program in Genetics, Ribeirão Preto Medical School, University of São Paulo (PGGEN-FMRP-USP), Ribeirão Preto, Brazil
- University Hospital, Federal University of Maranhão (HU-UFMA), São Luís, Brazil
- Clinical Research Center (CEPEC), University Hospital, Federal University of Maranhão (HU-UFMA), São Luís, Brazil
| | - Precil Diego Miranda de Menezes Neves
- Nephrology Division, Medical School, University of São Paulo (FM-USP), São Paulo, Brazil
- Molecular Medicine Discipline, Medical School, University of São Paulo (FM-USP), São Paulo, Brazil
- Nephrology and Dialysis Center, Oswaldo Cruz German Hospital, São Paulo, Brazil
| | - Joyce Santos Lages
- University Hospital, Federal University of Maranhão (HU-UFMA), São Luís, Brazil
| | - Kaile de Araújo Cunha
- University Hospital, Federal University of Maranhão (HU-UFMA), São Luís, Brazil
- Nephrology Service, University Hospital, Federal University of Maranhão (HU-UFMA), São Luís, Brazil
| | - Monique Pereira Rêgo Muniz
- University Hospital, Federal University of Maranhão (HU-UFMA), São Luís, Brazil
- Nephrology Service, University Hospital, Federal University of Maranhão (HU-UFMA), São Luís, Brazil
| | - Dyego José de Araújo Brito
- University Hospital, Federal University of Maranhão (HU-UFMA), São Luís, Brazil
- Nephrology Service, University Hospital, Federal University of Maranhão (HU-UFMA), São Luís, Brazil
| | - Andréia Watanabe
- Nephrology Division, Medical School, University of São Paulo (FM-USP), São Paulo, Brazil
- Molecular Medicine Discipline, Medical School, University of São Paulo (FM-USP), São Paulo, Brazil
| | - Elieser Hitoshi Watanabe
- Nephrology Division, Medical School, University of São Paulo (FM-USP), São Paulo, Brazil
- Molecular Medicine Discipline, Medical School, University of São Paulo (FM-USP), São Paulo, Brazil
| | - Luiz Fernando Onuchic
- Nephrology Division, Medical School, University of São Paulo (FM-USP), São Paulo, Brazil
- Molecular Medicine Discipline, Medical School, University of São Paulo (FM-USP), São Paulo, Brazil
| | - Lucas Lobato Acatauassu Nunes
- University Hospital Complex, João de Barros Barreto University Hospital, Federal University of Pará (HUJBB – UFPA), Belém, Brazil
| | | | - Flávia Lara Barcelos
- Nephrology Service, University Hospital of Brasilia, University of Brasília (HUB – UNB), Brasília, Brazil
| | - Giuseppe Cesare Gatto
- Nephrology Service, University Hospital of Brasilia, University of Brasília (HUB – UNB), Brasília, Brazil
| | - Antonio Monteiro
- Maria Aparecida Pedrossian University Hospital, Federal University of Mato Grosso do Sul (HUMAP – UFMS), Campo Grande, Brazil
| | | | | | - Thaísa de Oliveira Leite
- Nephrology Service, University Hospital of Lizard, Federal University of Sergipe (HUL - UFS), Lagarto, Brazil
| | - Felipe Leite Guedes
- Nephrology Service, Onofre Lopes University Hospital, Federal University of Rio Grande do Norte (HUOL-UFRN), Natal, Brazil
| | - Orlando Vieira Gomes
- University Hospital, Federal University of Vale do São Francisco (HU-UNIVASF), Petrolina, Brazil
| | | | | | | | | | | | | | - Carlos Eduardo Campos Maramaldo
- Laboratory of Immunology and Microbiology of Respiratory Infections (LIMIR), Maranhão University Center (CEUMA), São Luís, Brazil
| | - Lídio Gonçalves Lima Neto
- Laboratory of Immunology and Microbiology of Respiratory Infections (LIMIR), Maranhão University Center (CEUMA), São Luís, Brazil
| | - Weverton Machado Luchi
- Nephrology Service, Cassiano Antonio Moraes University Hospital, Federal University of Espírito Santo (HUCAM-UFES), Vitória, Brazil
| | - David Campos Wanderley
- Nephropathology Institute, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | | - Natalino Salgado Filho
- University Hospital, Federal University of Maranhão (HU-UFMA), São Luís, Brazil
- Nephrology Service, University Hospital, Federal University of Maranhão (HU-UFMA), São Luís, Brazil
| | - Gyl Eanes Barros Silva
- University Hospital, Federal University of Maranhão (HU-UFMA), São Luís, Brazil
- Nephrology Service, University Hospital, Federal University of Maranhão (HU-UFMA), São Luís, Brazil
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