Rhabdomyolysis in a hospitalized patient with COVID-19 – case report

Abstract

Introduction. COVID-19 is a viral infection with a variable clinical spectrum, ranging from asymptomatic carrier state to severe pneumonia. It is associated with a variety of complications, including musculoskeletal abnormalities. Whereas myalgia is a common clinical finding at these patients, only a few cases of COVID-19-associated rhabdomyolysis have been described in the literature. Case presentation. We describe the case of a 42-year old male confirmed with SARS-CoV-2 infection who presented to the emergency department with an 11-day evolution of dyspnea, cough, fatigue, myalgia and hyperchromic urine. The physical examination revealed dyspnea and an oxygen saturation of 87% while breathing ambient air, being otherwise normal. Blood tests showed neutrophilia, increased inflammatory markers, COVID-19 associated coagulopathy and elevation of muscular enzymes creatine-kinase and myoglobin. The chest computer tomography was consistent with mixed pneumonia, distributed in all pulmonary segments and the case was interpreted as a severe form of SARS-CoV-2 infection, associated with acute respiratory failure and rhabdomyolysis. Upon treatment (Enoxaparin, Aspirin, Dexamethasone, Favipiravir, oxygen administered by face mask, fluid resuscitation), his condition considerably improved, along with the laboratory findings, and he was discharged, without developing acute kidney injury or other complications related to rhabdomyolysis during his admission. Conclusion. COVID-19 patients can develop rhabdomyolysis, which can result in life-threating complications.