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September 29, 2021

Collapsing Glomerulopathy and APOL1 High-Risk Genotype Associated with Covid-19


Dr. May and Dr. Larsen discuss Covid-19 and its effect on collapsing glomerulopathy and APOL1 in Episode 3 of Arkana Advances.

Collapsing glomerulopathy is a variant of focal segmental glomerulosclerosis (FSGS) in which there is capillary loop collapse and epithelial cell hyperplasia and hypertrophy. There is rapid progression to end-stage renal disease. Early in the COVID-19 pandemic in the United States, these publications demonstrated for the first time that collapsing glomerulopathy is seen in African American patients with COVID-19 infection, and is associated with an APOL1 High-Risk genotype. Direct viral infection of the kidney parenchyma was not identified. NanoString analysis showed activation of genes involved in tubular injury, as well as chemokines/cytokines and immunoglobulin.  These findings are similar to that seen in HIV-associated nephropathy, wherein patients with an APOL1 high-risk genotype, HIV serves as a “second hit” to initiate collapsing glomerulopathy. Multiple publications have since confirmed, on a larger scale, the association of COVID-19 and collapsing glomerulopathy.

Read the papers: Collapsing Glomerulopathy in a patient with COVID-19 and AKI and Collapsing Glomerulopathy Associated with COVID-19 and APOL1 High-Risk Genotype

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