Dobrava hantavirus and coinciding SARS-CoV-2 infection mimicking thrombotic microangiopathy and responding to a single dose of eculizumab

S Aberger, N Kozakowski, Z Proházka, T Pleininger (Co-author), H Salmhofer* (Last author)

*Corresponding author for this work

Research output: Contribution to journalCase reportpeer-review

Abstract

The current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has refocused scientific interest on gaining insight into the pathophysiology of systemic viral diseases. Complement activation has been characterized as a driver of endothelial injury and microvascular thrombosis in acute respiratory distress syndrome as well as hantavirus hemorrhagic fever with renal syndrome. On this occasion, we wish to report a case of severe hantavirus disease with coinciding SARS-CoV-2 infection mimicking thrombotic microangiopathy with rapid response of inflammatory markers, hematologic parameters and proteinuria to eculizumab. These findings support a disease model of virus-associated endothelial injury involving alternative pathway complement activation. Future studies are needed to explore whether end organ damage can be mitigated by complement inhibition in life-threatening viral disease.
Original languageEnglish
Number of pages4
JournalCLINICAL KIDNEY JOURNAL
Early online dateSept 2023
DOIs
Publication statusPublished - 27 Sept 2023

Keywords

  • acute kidney injury
  • complement system
  • COVID-19
  • hantavirus
  • thrombotic microangiopathy
  • COMPLEMENT ACTIVATION

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