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Medical Science Monitor Basic Research


A 65-Year-Old Woman with a History of Type 2 Diabetes Mellitus and Hypertension and a 15-Day History of Dry Cough and Fever Who Presented with Acute Renal Failure Due to Infection with SARS-Cov-2

Challenging differential diagnosis, Educational Purpose (only if useful for a systematic review or synthesis), Rare coexistence of disease or pathology

Ángel Sánchez Tinajero, Elizabeth González Cueto, José A. Martínez Orozco, Eduardo Becerril Vargas, Danna P. Ruiz Santillán, Héctor Reséndiz Escobar

Mexico Laboratory of Clinical Microbiology, National Institute of Respiratory Diseases (INER), Mexico City, Mexico

Am J Case Rep 2020; 21:e926737

DOI: 10.12659/AJCR.926737

Available online: 2020-07-15

Published: 2020-07-25


BACKGROUND: Acute kidney injury is one of the most common complications in patients infected with SARS-CoV-2, occurring in up to 7% of cases and increasing to 23% in patients treated in the Intensive Care Unit (ICU). The objective of this report was to describe the clinical case of a patient infected by SARS-CoV-2 who developed acute renal injury, probably secondary to this infection.
CASE REPORT: On 1 April 2020, a 65-year-old woman presented to the emergency service of the National Institute of Respiratory Diseases, Mexico City, with a 15-day history of dry cough and subjective fever. Finally, the following diagnoses were integrated: Acute renal injury of etiology to be determined (acute chronic kidney disease secondary to T2DM vs. acute renal injury by SARS-CoV-2) and COVID-19. The patient had a typical presentation of severe COVID-19, evidencing all the risk and severity factors for this disease. However, after being admitted to the hospital, she showed evidence of acute renal injury. Although the renal injury may have been due to microangiopathic damage caused by chronic hypertension and diabetes, it is imperative to consider the possibility that such exacerbation contributes to SARS-CoV-2 infection or synergy of multiple factors.
CONCLUSIONS: Every aspect of this pandemic remains unclear. The formulation of hypotheses to explain the physiopathological mechanisms by which this new virus can cause mortality in infected patients may help reduce mortality rates and control the pandemic itself.

Keywords: acute kidney injury, Diabetes Mellitus, Hypertension, SARS Virus