Acute kidney injury caused by COVID-19 in a patient with Crohn’s disease treated with adalimumab

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 ulcers …