Post COVID-19 AA amyloidosis of the kidneys with rapidly progressive renal failure

ABSTRACT

Coronavirus disease 2019 (COVID-19) pandemic has taken the world by a storm, posing a gruelling challenge to the medical fraternity globally. Besides its very high infectivityinfectivity, significant organ dysfunction occurs in critically ill COVID-19 patients, leading to severe morbidity and mortality. Pulmonary involvement is the leading cause of death in these patients to be followed by the cardiovascular involvement. Kidney involvement due to COVID-19 is becoming more discernible with AKI adversely affecting the outcome. Besides AKI, a few cases of collapsing FSGS in genetically vulnerable patients and thrombotic microangiopathies have been reported as well. We report a case of AA amyloidosis of the kidney with a rapidly progressive renal failure and congestive heart failure with preserved left ventricular functions, which complicated a moderate COVID-19 pneumonia providing some clues to a possible association of this novel virus disease with this complication, which needs to be confirmed in future studies.

KEYWORDS:

• AA- Amyloidosis
• COVID-19
• Prion-like domains in SARS-CoV-2 spike protein
• rapidly progressive renal failure: segment SK-9 of SARS CoV-2
• renal AA amyloidosis

Contribution

T.H.M. conceptualized the manuscript, wrote the draft, and the entire discussion and was primarily involved in the management of the patient and finalized the manuscript.

P.A.Z. did an extensive cardiac evaluation of the patient, and contributed into writing the case and approved the manuscript.

A.S. and S.S. performed the histopathology, and contributed into writing the case and approved the manuscript.

B.J. performed most of the radiological testing and the literature search, and corrected and modified the final manuscript.

S.S. did the initial histopathology and approved the manuscript.

M.O.P. collected new data for the revision and arranged it them and approved the manuscript.

S.B. contributed into writing the revised manuscript and approved it.

R.J. contributed into writing the revised manuscript and approved it.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported that there is no funding associated with the work featured in this article.