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Severe Rhabdomyolysis in a 35-Year-old Woman with COVID-19 due to SARS-CoV-2 Infection: A Case Report.
Am J Case Rep. 2020 Aug 17; 21:e926733.AJ

Abstract

BACKGROUND

Rhabdomyolysis is a skeletal muscle injury that has different etiologies and can be a manifestation of coronavirus disease 2019 (COVID-19). Because it is a life-threatening condition, rapid diagnosis is necessary to prevent acute complications. Diagnostic criteria for rhabdomyolysis are elevated serum creatine kinase, liver enzyme levels, and myalgia. Rhabdomyolysis can easily be missed in patients with COVID-19. Herein, we report the case of a female with rhabdomyolysis as a manifestation of acute COVID-19. CASE REPORT A 35-year-old female was found to have rhabdomyolysis associated with COVID-19. Her creatine kinase and liver enzyme levels were significantly elevated. Ringer's lactate infusion was administered at a controlled rate to treat the rhabdomyolysis along with boluses of normal saline, with close monitoring of her oxygen saturation and kidney function. The patient's creatine kinase and liver enzyme levels peaked on Day 2 and then decreased. Her medical condition improved, and she was discharged on Day 4.

CONCLUSIONS

Our case highlights the need to monitor the creatine kinase level of hospitalized patients with COVID-19. Fluid management can be challenging in patients with rhabdomyolysis due to COVID-19 because of the risk of fluid overload and acute respiratory distress syndrome. Clinicians should be aware that a significant elevation in liver enzyme levels and myalgia can be the presenting features of rhabdomyolysis in patients with COVID-19.

Authors+Show Affiliations

Department of Hospital Medicine, Northeast Georgia Health System, Gainesville, GA, USA.Department of Graduate Medical Education, Internal Medicine Residency Program, Northeast Georgia Health System, Gainesville, GA, USA.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

32801291

Citation

Alrubaye, Riyadh, and Hasan Choudhury. "Severe Rhabdomyolysis in a 35-Year-old Woman With COVID-19 Due to SARS-CoV-2 Infection: a Case Report." The American Journal of Case Reports, vol. 21, 2020, pp. e926733.
Alrubaye R, Choudhury H. Severe Rhabdomyolysis in a 35-Year-old Woman with COVID-19 due to SARS-CoV-2 Infection: A Case Report. Am J Case Rep. 2020;21:e926733.
Alrubaye, R., & Choudhury, H. (2020). Severe Rhabdomyolysis in a 35-Year-old Woman with COVID-19 due to SARS-CoV-2 Infection: A Case Report. The American Journal of Case Reports, 21, e926733. https://doi.org/10.12659/AJCR.926733
Alrubaye R, Choudhury H. Severe Rhabdomyolysis in a 35-Year-old Woman With COVID-19 Due to SARS-CoV-2 Infection: a Case Report. Am J Case Rep. 2020 Aug 17;21:e926733. PubMed PMID: 32801291.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Severe Rhabdomyolysis in a 35-Year-old Woman with COVID-19 due to SARS-CoV-2 Infection: A Case Report. AU - Alrubaye,Riyadh, AU - Choudhury,Hasan, Y1 - 2020/08/17/ PY - 2020/8/18/entrez PY - 2020/8/18/pubmed PY - 2020/9/2/medline SP - e926733 EP - e926733 JF - The American journal of case reports JO - Am J Case Rep VL - 21 N2 - BACKGROUND Rhabdomyolysis is a skeletal muscle injury that has different etiologies and can be a manifestation of coronavirus disease 2019 (COVID-19). Because it is a life-threatening condition, rapid diagnosis is necessary to prevent acute complications. Diagnostic criteria for rhabdomyolysis are elevated serum creatine kinase, liver enzyme levels, and myalgia. Rhabdomyolysis can easily be missed in patients with COVID-19. Herein, we report the case of a female with rhabdomyolysis as a manifestation of acute COVID-19. CASE REPORT A 35-year-old female was found to have rhabdomyolysis associated with COVID-19. Her creatine kinase and liver enzyme levels were significantly elevated. Ringer's lactate infusion was administered at a controlled rate to treat the rhabdomyolysis along with boluses of normal saline, with close monitoring of her oxygen saturation and kidney function. The patient's creatine kinase and liver enzyme levels peaked on Day 2 and then decreased. Her medical condition improved, and she was discharged on Day 4. CONCLUSIONS Our case highlights the need to monitor the creatine kinase level of hospitalized patients with COVID-19. Fluid management can be challenging in patients with rhabdomyolysis due to COVID-19 because of the risk of fluid overload and acute respiratory distress syndrome. Clinicians should be aware that a significant elevation in liver enzyme levels and myalgia can be the presenting features of rhabdomyolysis in patients with COVID-19. SN - 1941-5923 UR - https://www.unboundmedicine.com/medline/citation/32801291/Severe_Rhabdomyolysis_in_a_35_Year_old_Woman_with_COVID_19_due_to_SARS_CoV_2_Infection:_A_Case_Report_ L2 - https://www.amjcaserep.com/download/index/idArt/926733 DB - PRIME DP - Unbound Medicine ER -