• Hélène Lazareth, Hélène Péré, Yannick Binois, Melchior Chabannes, Juliet Schurder, Thomas Bruneau, Alexandre Karras, Eric Thervet, Marion Rabant, David Veyer, and Nicolas Pallet.
• Service de Néphrologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France; Hôpital Européen Georges Pompidou, Faculté de Médecine Centre Université de Paris, Université, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France. Electronic address: helene.lazareth@aphp.fr.
• Am. J. Kidney Dis. 2020 Oct 1; 76 (4): 590-594.

AbstractWe report a case of a kidney transplant recipient who presented with acute kidney injury and nephrotic-range proteinuria in a context of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Kidney biopsy revealed collapsing glomerulopathy. Droplet-based digital polymerase chain reaction did not detect the presence of SARS-CoV-2 RNA in the biopsy fragment, and the virus was barely detectable in plasma at the time of the biopsy. SARS-CoV-2 RNAemia peaked several days later, followed by a seroconversion despite the absence of circulating CD19-positive lymphocytes at admission due to rituximab-based treatment of antibody-mediated rejection 3 months earlier. Genotyping for the 2 risk alleles of the apolipoprotein L1 (APOL1) gene revealed that the donor carried the low-risk G0/G2 genotype. This case illustrates that coronavirus disease 2019 infection may promote a collapsing glomerulopathy in kidney allografts with a low-risk APOL1 genotype in the absence of detectable SARS-CoV-2 RNA in the kidney and that podocyte injury may precede SARS-CoV-2 RNAemia.Copyright © 2020 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

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