Search

Background: SARS-CoV-2 infection has, as of April 2021, affected >133 million people worldwide, causing >2.5 million deaths. Because the large majority of individuals infected with SARS-CoV-2 are asymptomatic, major concerns have been raised about possible long-term consequences of the infection., Methods: Wedeveloped an antigen capture assay to detect SARS-CoV-2 spike protein in urine samples from patients with COVID-19whose diagnosis was confirmed by positive PCR results from nasopharyngeal swabs (NP-PCR+) forSARS-CoV-2. We used a collection of 233 urine samples from 132 participants from Yale New Haven Hospital and the Children's Hospital of Philadelphia that were obtained during the pandemic (106 NP-PCR+ and 26 NP-PCR-), and a collection of 20 urine samples from 20 individuals collected before the pandemic., Results: Our analysis identified 23 out of 91 (25%) NP-PCR+ adult participants with SARS-CoV-2 spike S1 protein in urine (Ur-S+). Interestingly, although all NP-PCR+ children were Ur-S-, one child who was NP-PCR- was found to be positive for spike protein in their urine. Of the 23 adults who were Ur-S+, only one individual showed detectable viral RNA in urine. Our analysis further showed that 24% and 21% of adults who were NP-PCR+ had high levels of albumin and cystatin C, respectively, in their urine. Among individuals with albuminuria (>0.3 mg/mg of creatinine), statistical correlation could be found between albumin and spike protein in urine., Conclusions: Together, our data showed that one of four individuals infected with SARS-CoV-2 develop renal abnormalities, such as albuminuria. Awareness about the long-term effect of these findings is warranted., Competing Interests: A.I. Ko reportsreceiving research funding from Bristol Myers Squibb, Regeneron, Serimmune, and Tata Medical and Diagnostics; and having consultancy agreements with Tata Medical and Diagnostics. D.G. Moledina reports receiving honoraria from the British Medical Journal, National Kidney Foundation, and Remedy Health Media; serving as an editorial board member for Kidney360; receiving research funding from National Institute of Diabetes and Digestive and Kidney Diseases (grants K23DK117065, R01DK12681, UH3DK114866, and P30DK079310), outside the submitted work; and being a coinventor of the pending patent application “Methods and Systems for Diagnosis of Acute Interstitial Nephritis,” which is subject to an option for a license agreement with RenalytixAI Inc. A.R. John reports receiving research funding from the Burroughs Wellcome Fund and National Institutes of Health (NIH); being a scientific advisor for, or member of, Pluton Biosciences; and having patents and inventions involving antimalarials and malaria and SARS-CoV-2 biomarkers. V. Rao reports patents and inventions with Corvidia Therapeutics, and having consultancy agreements with Translational Catalyst. J. Testani reports receiving research funding from Abbott, Boehringer Ingelheim, Bristol Myers Squibb, 3ive Labs, Merck, NIH, Otsuka, Sanofi, Sequana Medical, The Foundry, and the US Food and Drug Administration; having consultancy agreements with, and receiving honoraria from, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Cardionomic, FIRE1, Lexicon, Magenta Med, Merck, Novartis, Regeneron, Reprieve, Sanofi, Sequana Medical, Windtree Therapeutics, and W.L. Gore; having patents and inventions with Corvidia, Reprieve Inc., and Yale University; and having ownership interest in Reprive Inc. All remaining authors have nothing to disclose., (Copyright © 2021 by the American Society of Nephrology.)