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COVID-19-Associated Rhabdomyolysis in Hospitalized Patients: Retrospective Cohort Study.
Paula Esquerdo-Serrano1, Silvia Otero-Rodriguez2, Hector Pinargote-Celorio2
1Pneumology Department, Dr. Balmis General University Hospital. Alicante Institute of Healthcare and Biomedical Research (ISABIAL), Alicante, Spain.
Saudi Medical Journal
|June 4, 2026
Summary
Rhabdomyolysis is an uncommon yet severe complication of COVID-19, primarily affecting males. This condition is frequently linked to acute kidney injury and significantly increases the risk of in-hospital mortality.
Area of Science:
- Infectious Diseases
- Nephrology
- Critical Care Medicine
Background:
- COVID-19 has been associated with various complications, including muscle damage.
- Rhabdomyolysis, a condition involving severe muscle breakdown, has been anecdotally reported in COVID-19 patients.
- Understanding the incidence and clinical impact of rhabdomyolysis in COVID-19 is crucial for patient management.
Purpose of the Study:
- To determine the frequency of rhabdomyolysis in hospitalized COVID-19 patients.
- To characterize the clinical features and outcomes of COVID-19 patients who develop rhabdomyolysis.
- To identify factors associated with in-hospital mortality in this cohort.
Main Methods:
- Single-center retrospective cohort study of adult COVID-19 patients admitted between March 2020 and March 2024.
- Rhabdomyolysis defined by a creatine kinase (CK) level of 1000 U/L or higher.
- Comparison of demographic, clinical, laboratory, treatment, and outcome data between patients with and without rhabdomyolysis.
Main Results:
- The cumulative incidence of rhabdomyolysis was 0.26% (20 out of 7,590 patients).
- Male sex was independently associated with a higher risk of rhabdomyolysis (adjusted OR 4.35).
- Rhabdomyolysis was linked to a higher incidence of acute kidney injury (60%), need for hemodialysis (15%), and in-hospital mortality (35% vs. 11.5%).
Conclusions:
- Rhabdomyolysis is an infrequent but serious complication of COVID-19.
- Male patients are predominantly affected and face increased risks of kidney injury and mortality.
- Early recognition and management of rhabdomyolysis may be important in severe COVID-19 cases.
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