Rhabdomyolysis or Myositis following a SARS-CoV-2 Vaccination.

Abstract

We read with interest the article by Kalekar et al about a 31 years old female (health care worker) with a sedentary lifestyle, who developed myalgia and muscle swelling of the right lower leg muscles 10 days after vaccination with a recombinant chimpanzee adenovirus vector vaccine encod-ing the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike (S) glycoprotein (vector-based, presum-ably AstraZeneca vaccine). 1 One day later, pain occurred also in the shoulder muscles bilaterally. 1 Treatment and outcome were not reported. 1 The study is appealing but has several limitations that raise concerns and should be discussed. We disagree with the statement in the discussion that there is no previous evidence of any postvaccination rhabdomyolysis in association with the use of vector-based vaccines. 1 In a recent report by Cirillo et al, rhabdomyolysis was diagnosed in a 68 years old, previously healthy male 9 days after the fi rst dose of the AstraZeneca vaccine. 2 The patient developed multiorgan failure involving bone mar-row, liver, lung, and kidneys, which was treated with steroids, anakinra, and eculizumab. 2 Despite this treatment, the patient died from multilineage cytopenia, untreatable hypotensive shock, and hypoglycemia and 48 days after vaccination. 2 There