The mechanisms of renal involvement in COVID-19 are still unclear, but there is a proposed multifactorial pathway: direct viral action and replication causing renal dysfunction; imbalance in the homeostasis of the renin-angiotensin-aldosterone system; deregulation of the complement system cascade; management of fluid therapy during the treatment of ARDS; procoagulant state; and consequence of a “cytokine storm” by the systemic inflammatory response. Here, REN is linked to acute respiratory distress syndrome.