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COVID-19-Related Rhabdomyolysis: A Case Report and Literature Review
Apurva Ashok1, Alifya A Lokhandwala1, Seohyeon Im1
1Internal Medicine, Mass General Brigham Salem Hospital, Salem, USA.
Abstract:
Rhabdomyolysis is the release of myoglobin, creatine kinase (CK) and potassium from damaged skeletal muscle into the bloodstream. This can result in life-threatening complications such as arrhythmias, kidney failure, disseminated intravascular coagulation (DIC) and cardiac arrest. The risk of developing rhabdomyolysis in COVID-19 has been published in a handful of case reports and series, although most of the patients in these studies have a strong comorbid history. We present a healthy 21-year-old male patient who presented with CK levels of >450,000 U/L two weeks after non-specific flu-like symptoms, in the absence of a second triggering event, but was found to be COVID-positive. In addition, the cardiac-specific troponins and liver function tests were deranged, which prompted investigations for hepatitis and myocarditis. Broad infectious work-up and imaging studies were negative, and the patient's laboratory derangements were significantly improved >70% after seven days of hospital admission. We also highlight the current literature available about this topic, mainly limited to case reports.
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