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Complement activation has been characterized as a driver of endothelial injury and microvascular thrombosis in acute respiratory distress syndrome as well as hantavirus hemorrhagic fever with renal syndrome. On this occasion, we wish to report a case of severe hantavirus disease with coinciding SARS-CoV-2 infection mimicking thrombotic microangiopathy with rapid response of inflammatory markers, hematologic parameters and proteinuria to eculizumab. These findings support a disease model of virus-associated endothelial injury involving alternative pathway complement activation. Future studies are needed to explore whether end organ damage can be mitigated by complement inhibition in life-threatening viral disease.<\/jats:p>","DOI":"10.1093\/ckj\/sfad222","type":"journal-article","created":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T05:14:11Z","timestamp":1695878051000},"page":"2750-2753","source":"Crossref","is-referenced-by-count":3,"title":["Dobrava hantavirus and coinciding SARS-CoV-2 infection mimicking thrombotic microangiopathy and responding to a single dose of eculizumab"],"prefix":"10.1093","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5721-2595","authenticated-orcid":false,"given":"Simon","family":"Aberger","sequence":"first","affiliation":[{"name":"Department of Internal Medicine I, Paracelsus Medical University , Salzburg , 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