Coronavirus Disease 2019-associated Minimal Change Disease: Transient Improvement Does Not Preclude the Need for Standard Therapy in a Case Report and Review of the Literature

Abstract

Minimal change disease can be associated with coronavirus disease 2019 (COVID-19). We herein report a 38-year-old woman who developed biopsy-proven minimal change disease 5 days after COVID-19 infection. Initial observation showed some spontaneous reduction in proteinuria, which later worsened. Treatment with low-dose prednisolone (0.4 mg/kg/day) led to temporary improvement; however, relapse occurred upon tapering. Complete remission required addition of cyclosporine and rituximab. This case suggests that although COVID-19-associated nephrotic syndrome may initially improve post-infection, standard-dose immunosuppressive therapy may be necessary if complete remission is not achieved.