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Malignant hyperthermia in severe COVID-19: 2 case reports.
Solmaz Ehteshami-Afshar1, Roozbeh Nikooie1, Pranav Reddy1
1Department of Medicine, Yale University School of Medicine, New Haven, Connecticut.
Emergency and Critical Care Medicine
|April 17, 2024
Summary
Malignant hyperthermia, a rare condition, was suspected in two intubated COVID-19 patients. Their differing responses to treatment highlight challenges in managing these complex cases.
Area of Science:
- Anesthesiology
- Critical Care Medicine
- Infectious Diseases
Background:
- Malignant hyperthermia is a rare, life-threatening pharmacogenetic disorder of skeletal muscle.
- Coronavirus disease 2019 (COVID-19) can cause severe respiratory failure requiring intubation.
- Intubation and mechanical ventilation present unique challenges in critically ill patients.
Observation:
- Two young patients with COVID-19 developed severe hyperthermia post-intubation, raising suspicion for malignant hyperthermia.
- Both patients required intubation due to hypoxic respiratory failure.
- The patients exhibited distinct clinical responses to conservative management and dantrolene administration.
Findings:
- Hyperthermia in intubated COVID-19 patients can mimic malignant hyperthermia.
- Individual patient responses to standard malignant hyperthermia treatments may vary.
- Differentiating true malignant hyperthermia from other causes of hyperthermia is critical.
Implications:
- These cases underscore the diagnostic and therapeutic complexities of managing intubation-related complications in COVID-19 patients.
- Clinicians must consider alternative diagnoses for hyperthermia in critically ill COVID-19 patients.
- Further research is needed to understand the pathophysiology and optimal management of hyperthermia in this population.
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