Potential Role of High-Dose Steroids in the Treatment of COVID-19-Associated Nephropathy

With the increasing number of COVID-19-associated nephropathy (COVAN), biopsy-proven cases of collapsing variety of focal segmental glomerulosclerosis (FSGS) are emerging. Though the recommendations on treatment for COVID-19-associated respiratory symptoms are evolving, there is still no definitive treatment for the collapsing FSGS secondary to COVAN. We report a case of a 47-year-old male admitted with acute kidney injury from COVID-19 infection and found to have collapsing FSGS on renal biopsy. Almost all the patients who were found to have similar conditions were treated with a relatively smaller dose of steroids and ultimately required dialysis. Our patient showed improvement with the trial of higher doses of steroids and never required dialysis. Hence, our case report emphasizes the need for a randomized controlled trial (RCT) with regard to the use of high-dose steroids in COVAN.