It is not the first time that a virus mainly involving the respiratory tract can also involve the kidney, as it has been already reported during the course of the SARS epidemic in 2003 [8,107]. AKI represents a life-threatening complication, often leading to increased risk of death. One possible explanation of the high prevalence of kidney involvement at hospital admission is that some of the COVID-19 patients may already have had a history of CKD. Such patients tend to have a pro-inflammatory state with functional defects in their immune system [108] and are at a higher risk for upper respiratory tract infection and pneumonia. Cheng et al. [8], as mentioned before, in their study of a cohort of 701 patients found that 5.1% of patients developed AKI during hospitalization. Patients with increased baseline serum creatinine levels were more likely to develop AKI (11.9%) than patients with normal baseline values (4.0%). This means that, while renal complications are more likely in patients with pre-existing chronic impairment of kidney function, moderate-to-severe AKI can also be found in patients with normal serum creatinine levels these may represent a higher-risk subset of patients with ARDS. Wilson et al. [109] noted that similar observations have been reported for COVID-19-associated ARDS, which could develop into AKI on average 9 days after admission together with secondary infections and acute cardiac damage [26]. In ARDS, patients age, severity of illness and the presence of diabetes are all risk factors for acute kidney injury. Furthermore, the patient’s BMI value and any previous history of heart failure may also be associated with the severity of AKI. All these risk factors may count for the higher incidence of AKI in the elderly. Hirsch et al. recently analyzed risk factors, clinical presentation and outcomes of AKI among hospitalized COVID-19 patients in the metropolitan New York area, encompassing twenty three hospitals within urban and suburban areas and including academic tertiary and community hospitals. They found that among those with AKI, 694 died (35%), 519 (26%) were discharged and 780 (39%) were still hospitalized. In addition to the known risk factors for AKI mentioned before, namely older age, cardiovascular disease, hypertension, diabetes mellitus and need for ventilation and of vasopressor drugs, black race was also included among them. Indeed, individuals from minority communities, in particular African Americans and Hispanics have been disproportionately affected by and have had worse outcomes after SARS-CoV-2 infection. Finally, they did not find that use of blockers of the Renin-Angiotensin and aldosterone system at hospital admission for COVID-19 disease was associated with greater AKI risk. As expected, in their study involving different ethnicities in U.S.A., they confirmed that early AKI occurs frequently among COVID-19 patients and in temporal association with respiratory failure, with a consequent poor prognosis [110].