SHM Converge Scientific Abstract ePoster Gallery-A Case of Covid Associated Nephropathy (Covan)

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This case report describes a 52-year-old African American woman with atrial fibrillation, hypertension, and obesity who was hospitalized with COVID-19 symptoms including cough, fever, fatigue, and shortness of breath. Although she did not initially require oxygen, she developed acute kidney injury (AKI) that worsened despite intravenous fluids, prompting renal ultrasound and nephrology consultation.<br /><br />Given her rapid renal decline and significant proteinuria, clinicians suspected COVID-associated nephropathy (COVAN), a collapsing form of focal segmental glomerulosclerosis linked to COVID-19, particularly in patients with APOL1 risk alleles. The patient was later found to be APOL1 positive. Nephrology did not recommend kidney biopsy or steroids initially, but when her respiratory condition worsened, she was started on steroids. Her kidney function improved, with creatinine decreasing from a peak of 4.3 mg/dL to 2.26 mg/dL at discharge.<br /><br />The report explains that collapsing glomerulonephropathy has also been associated with other viral infections such as HIV, CMV, parvovirus, and EBV. In COVAN, interferon activation appears to trigger APOL1-associated podocyte injury, mitochondrial dysfunction, and glomerular cell death. The authors emphasize that AKI is common in COVID-19, especially in critically ill patients, and that COVAN should be considered when kidney injury is accompanied by proteinuria, particularly in African American patients or those with APOL1 risk variants.<br /><br />The case highlights the importance of distinguishing COVAN from pre-renal AKI and suggests that early recognition of this entity may have important public health implications and guide future research into anti-inflammatory therapies for high-risk patients.

Asset Subtitle

Taylor Craig

Meta Tag

Author List Amro Abdelghani, Moiz Ansari, Parker Foster, Pinky Jha, Taylor Craig, Yasir Abdelgadir

Category Clinical Vignettes

Concept Collapsing Glomerulopathy

Concept COVID-19-associated Nephropathy

Concept Acute Kidney Injury

Concept APOL1 Risk Allele

Concept Proteinuria

Distinguished Non-Finalist

Presenter Organization Medical College of Wisconsin

Presenting Author Taylor Craig

Track Adult

Keywords

COVID-19

acute kidney injury

COVID-associated nephropathy

COVAN

APOL1

collapsing glomerulopathy

proteinuria

African American

focal segmental glomerulosclerosis

steroids

Collapsing Glomerulopathy

COVID-19-associated Nephropathy

Acute Kidney Injury

APOL1 Risk Allele

Proteinuria