ABSTRACT Background and objectives Glomerular C3 deposition is often observed in renal biopsies of patients with IgA nephropathy (IgAN), however, the relationship between the level of C3 deposition and the long-term prognosis of IgAN have rarely been reported. In this observational cohort study, we aimed to evaluate the prognostic value of glomerular C3 deposition in the progression of IgAN. Materials and Methods From June 2009 to June 2010, a total of 136 adult patients with IgAN were enrolled in the study. Glomerular deposition of the complement protein C3, immune complexes, and inflammatory cells were detected in renal biopsy tissue. The level of renal lesions, glomerular immune complexes, and the density of interstitial inflammatory cells were analyzed. Based on an average of 105 months of follow-up, the predictive value of glomerular C3 deposition for IgAN progression was investigated. Results Of the 136 patients, 102 patients were classified into the glomerular C3low group and 34 patients were classified into the glomerular C3high group. Patients in C3high group had more immune complexes deposition than those in C3low group. In C3high group, the degree of renal lesion and interstitial fibrosis were severer compared to C3low group. Renal biopsy in C3high group presented with higher density of interstitial inflammatory cells that in C3low group. The density of glomerular C3 deposition was associated with poor renal survival over a 105-month follow-up. Conclusions The high density of glomerular C3 deposition was associated with severity of renal lesions and predicted a long-term poor renal survival for IgAN patients.

Background: Little is known about whether coinfection of other respiratory tract viruses contributes to severity of COVID-19 pneumonia. Methods: We retrospectively studied 128 hospitalized patients with COVID-19 pneumonia (64 cases co-infected with influenza A/B vs 64 negative influenza cases via pair-matching on age, sex, and days from onset of symptom). Results: Among 64 co-infected patients, 54 patients (84.4%) had co-infected with influenza A, and 10 (15.6%) with influenza B. The percentages for the severity of pneumonia on admission of the two groups, i.e., with influenza infection and without, were similar (P=0.945). The median duration (days) of viral shedding time from admission was longer for patients with influenza infection (17.0 day) than those without influenza infection (12.0 day) (P<0.001). However, the progression of lung CT in four weeks after onset of symptom were similar in both groups. The multivariable Cox proportional hazards model showed that the HR of pneumonia resolution on CT scans was 0.869 (P=0.612) for patients with influenza (95% CI 0.505, 1.495) compared with patients without influenza, while the HR of resolution in lung involvement was 1.878 (P=0.020) for patients with lopinavir/ritonavir, compared with patients without lopinavir/ritonavir (95% CI 1.103, 3.196). Patients who were treated with lopinavir/ritonavir presented with faster pneumonia resolution in two weeks after symptom onset both in the whole cohort (32.4% vs 13.8%, P=0.036) and in influenza co-infected group (37% vs 1%, P=0.001). Conclusions: Lopinavir/ritonavir eliminated the difference of lung involvement between influenza co-infected and non-infected groups, indicating lopinavir/ritonavir is associated with pneumonia resolution in COVID-19.