COVID-19 infects kidney cells, stimulates fibrosis in kidney organoids
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The COVID-19 virus can directly infect kidney cells and cause cell injury due to increased fibrosis risk, according to data published in Cell Stem Cell.
Further, these findings may explain AKI in patients with COVID-19 and the development of chronic kidney disease in patients with long-term COVID.
“Upon the emergence of the COVID-19 pandemic at the beginning of 2020, doctors from Wuhan in China soon reported acute kidney failure linked to SARS-CoV-2 infection in patients. At this point, it was not clear if and how the virus affected kidney health,” Jitske Jansen, PhD, a postdoctoral researcher at the University Hospital RWTH Aachen in Aachen, Germany, told Healio. “We wanted to shed light on these unanswered questions and found that kidney cells indeed do get infected by SARS-CoV-2 and provided a potential explanation as to why the infection may cause kidney injury. More recent data points toward kidney functional loss in long COVID and our data suggests that fibrosis might be one mechanism that could explain this finding.”
Researchers modelled COVID-19 infection in vitro by infecting human induced pluripotent stem cell-derived kidney organoids with the COVID-19 virus. On day 7 (+18) researchers injected the organoids with the virus particles and used viral RNA expression to confirm the infection. Analyses determined whether the virus was detected in different particles, and Masson’s Trichrome staining quantified potential fibrosis in organoids.
Results revealed that the COVID-19 virus correlates with increased collagen 1 protein expressions in organoids. Not only can the COVID-19 virus directly infect kidney cells, but it can also drive fibrosis and lead to cell injury, according to the researchers.
“We uncovered an association between kidney scarring and COVID-19 in patients. In our organoid experiments, we found pro-fibrotic signaling in kidney cells upregulated upon SARS-CoV-2 infection,” Katharina C. Reimer, MD, a physician scientist and nephrologist in training at the University Hospital RWTH Aachen in Aachen, Germany, told Healio. “Whether the virus indeed causes the scarring in patients needs further investigation, but our work clearly points into this direction. The best way to protect the kidney in the current situation is to get vaccinated and boostered and to prevent infection by social distancing and masks. To date, there is no specific treatment for kidney fibrosis. Whether novel antivirals that are being developed are protective for the kidney has to be studied.”
“Our findings show that investigating the link between kidney injury and COVID-19 requires clinical attention,” Jansen told Healio. “If it holds true that SARS-CoV-2 causes kidney fibrosis in patients, COVID-19 follow-up examinations should include screening for signs of kidney injury.”
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