PMC7522604_01
Kidney biopsy: representative light microscopy shows global collapse of the glomerular capillary loops accompanied by hyperplasia and hypertrophy of overlying glomerular epithelial cells (a-c) many of which contain scattered eosinophilic protein droplets (a, arrow) and numerous intracytoplasmic vacuoles (b, arrows). a: Jones methenamine silver stain; b: H&E stain; c: Masson's trichrome stain, x400. Acute tubular injury is manifest in many cortical tubules, accompanied by interstitial edema and patchy interstitial mononuclear inflammatory infiltrates (d: H&E stain, x400).
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fig1
All but one displayed segmental or global collapse, implosion of the glomerular capillary tuft, and enlargement of Bowman space (Figure 1).
Changes in serum creatinine and proteinuria with time in a 48-year-old African male admitted for acute kidney injury with COVID-19.
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fig2
The patient received pulse therapy with methyl prednisolone intravenously, 500 mg on days 1, 2, and 3, and cyclophosphamide intravenously, 500 mg day 1; despite this therapy, proteinuria remains still heavy (4 g per day).  Figure 2 shows changes in serum creatinine and proteinuria with time.