Acute kidney injury associated with <scp>COVID</scp> ?19—Cumulative evidence and rationale supporting against direct kidney injury (infection)

Acute kidney injury (AKI) is a common complication, affecting up to 37% of hospitalized patients with SARS-CoV-2 infection and proportional its severity portends poor prognosis. Diverse mechanisms have been proposed studies reported conflicting results. Moreover, renal tropism does not equate pathogenicity. For virus be pathogenic, in addition affinity (tropism) for specific tissue(s), host cells must allow viral entry, discuss the important role played by transmembrane protease, serine 2 (TMPRSS2) coexpression both ACE2 TMPRSS2 same cause damage. Lack kidneys limiting factor direct effects kidney. We present rationale cumulative evidence supporting that AKI secondary hemodynamic immunologic than or infection.