Acute kidney injury is a commonly described complication of COVID-19 that has been linked to increased morbidity and mortality. Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been found in the kidney,1 the clinical effect remains unclear.2 Here, we present data from a post-mortem series of 63 patients who had SARS-CoV-2 respiratory infection (appendix pp 2–3), linking SARS-CoV-2 renal tropism to clinical outcome and acute kidney injury.