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Acute kidney injury caused by COVID-19 in a patient with Crohn’s disease treated with adalimumab
  1. Marco Vincenzo Lenti1,
  2. Marilena Gregorini2,
  3. Federica Borrelli de Andreis1,
  4. Teresa Rampino2,
  5. Gioacchino D'Ambrosio3,
  6. Laura Verga3,
  7. Alessandro Vanoli3,
  8. Caterina Mengoli1,
  9. Valentina Ravetta1,
  10. Marco Paulli3,
  11. Antonio Di Sabatino1
  1. 1 First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
  2. 2 Department of Nephrology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
  3. 3 Department of Pathology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
  1. Correspondence to Professor Antonio Di Sabatino, First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Pavia 27100, Italy; a.disabatino{at}

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COVID-19, caused by SARS-CoV-2, has become a global threat in a matter of months. In particular, Italy has been one of the most affected areas worldwide. Data regarding the clinical picture and clinical course of COVID-19 are still lacking, especially in non-Asian populations. COVID-19 usually causes an influenza-like syndrome, including cough, fever, sore throat, muscle pain, and in some cases a more severe clinical picture, including interstitial pneumonia with acute respiratory distress syndrome, which may be fatal.1 Acute kidney failure has been reported in a substantial proportion of patients with COVID-19,1 2 but little is known regarding the mechanisms leading to kidney injury. Besides fluid depletion, which is expected to be common, a direct damage caused by the virus could be potentially responsible for kidney injury. In fact, as it has been recently hypothesised, SARS-CoV-2 may reach the kidney, as well as other organs, via viral sepsis.3 In turn, this process might be favoured by a defective immune response towards the virus, as in the case of patients treated with immunomodulant drugs, including biological therapies. The impact of COVID-19 in patients suffering from inflammatory bowel disease, particularly those treated with biological agents, is poorly characterised, and data are still emerging.

We here describe the unique clinical course of a COVID-19 patient with Crohn’s disease (CD) under biological therapy who was admitted to our internal medicine unit for acute kidney injury.

A 25-year-old man has been suffering from CD since the age of 18, when he underwent a colonoscopy that showed multiple …

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  • Handling editor Tahir S Pillay.

  • MVL and MG contributed equally.

  • Contributors All authors participated in the drafting of the paper, made critical revision of the manuscript for important intellectual content and provided approval of the final submitted version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.