SARS-CoV-2 infects the human kidney and drives fibrosis in kidney organoids, 2021, Jansen et al

Highlights

• COVID-19 patients present tubulo-interstitial kidney fibrosis compared with controls
• SARS-CoV-2 infection stimulates profibrotic signaling in human kidney organoids
• SARS-CoV-2 infection can be inhibited by a protease blocker in human kidney organoids

Summary

Kidney failure is frequently observed during and after COVID-19, but it remains elusive whether this is a direct effect of the virus. Here, we report that SARS-CoV-2 directly infects kidney cells and is associated with increased tubule-interstitial kidney fibrosis in patient autopsy samples. To study direct effects of the virus on the kidney independent of systemic effects of COVID-19, we infected human-induced pluripotent stem-cell-derived kidney organoids with SARS-CoV-2. Single-cell RNA sequencing indicated injury and dedifferentiation of infected cells with activation of profibrotic signaling pathways. Importantly, SARS-CoV-2 infection also led to increased collagen 1 protein expression in organoids. A SARS-CoV-2 protease inhibitor was able to ameliorate the infection of kidney cells by SARS-CoV-2. Our results suggest that SARS-CoV-2 can directly infect kidney cells and induce cell injury with subsequent fibrosis. These data could explain both acute kidney injury in COVID-19 patients and the development of chronic kidney disease in long COVID.

Open access, https://www.sciencedirect.com/science/article/pii/S1934590921005208