AKI and Collapsing Glomerulopathy Associated with COVID-19 and APOL1 High-Risk Genotype

Kidney involvement may occur in coronavirus disease 2019 (COVID-19), and can be severe among Black individuals. In this study of collapsing glomerulopathy in six Black patients with COVID-19, the authors found that all six had variants in the gene encoding apo L1 (APOL1) that are more common among those of African descent and linked by past research to susceptibility to collapsing glomerulopathy in non–COVID-19 patients. They found no evidence of direct kidney viral infection but observed changes in gene expression in kidney biopsy samples suggesting that the mechanism is likely driven by a host response. These findings suggest that Black individuals with an APOL1 high-risk genotype and severe acute respiratory syndrome coronavirus 2 infection are at increased risk for experiencing an aggressive form of kidney disease associated with high rates of kidney failure.