Xuejing Zhu

and 13 more

Kidney injury is common in patients with Coronavirus Disease-19 (COVID-19). In this study, 49 patients with Omicron associated kidney injury were included, 38 of whomperformed renal biopsy. Patients were divided into 2 groups: Group A for patients developing kidney injury afterSARS-CoV-2 infection and Group B for patients with aggravated renal insufficiency after SARS-CoV-2 infection. The clinical, pathological and prognostic characteristicsof the patients and theirC3 levels were observed.In our center, the clinical diagnoses of patients with COVID-19 associated kidney injury were mainly acute kidney injury(AKI), chronic kidney disease(CKD) and nephrotic syndrome(NS); while the pathological diagnoses were mainly IgA nephropathy(IgAN)、focal segmental glomerulosclerosis(FSGS) and membranous nephritis(MN).80% of COVID-19 associated nephropathy (COVAN) patients had normal serum C3 complement level, and a few patients had increased or decreased C3 level. In renal tissue, C3 deposits were observed in 68.4% of patients.29% of patients experienced deterioration of renal function after treatment, but no patients developed to end-stage renal disease (ESRD). Among all of them, one case presenting with thrombotic microangiopathy (TMA) had a more severe renal pathological lesion and poorer prognosis. We observed differences of clinical and pathological features of patients with COVID-19associated kidney injury between races, regions and virus variants. Asian patients with Omicron associated kidney injury have milder kidney injury and a better renal prognosis.