Introduction Though initially believed to primarily be a respiratory pathogen, the SARS-CoV-2 virus has manifested as a virus that has the potential to affect multiple organ systems causing a wide variety of disease and symptomatology. Case Presentation Here we present a teenager with acute COVID-19 who presented to the hospital with severe rhabdomyolysis causing life-threatening hyperkalemia and acute kidney injury requiring treatment with emergent renal replacement therapy in the intensive care unit. Conclusions Rhabdomyolysis and acute kidney injury are increasingly recognized as complications of acute SARS-CoV-2 infection, and require vigilance given the associated risk of morbidity and mortality.

Though initially believed to primarily be a respiratory pathogen, the SARS-CoV-2 virus has manifested as a virus that has the potential to affect multiple organ systems causing a wide variety of disease and symptomatology. Children have been largely spared in comparison to adult morbidity and mortality; however, acute pediatric illness secondary to COVID-19 infection has become both more common and more serious. Here, we present a teenager with acute COVID-19 who presented to the hospital with profound weakness and oliguria and was discovered to have severe rhabdomyolysis causing life-threatening hyperkalemia and acute kidney injury. He required treatment with emergent renal replacement therapy in the intensive care unit. His initial CK was 584,886 U/L. Creatinine was 14.1 mg/dL and potassium was 9.9 mmol/L. He was successfully treated with CRRT and was discharged on hospital day 13 with normal kidney function on follow-up. Rhabdomyolysis and acute kidney injury are increasingly recognized as complications of acute SARS-CoV-2 infection and require vigilance given the potentially fatal complications and long-standing morbidity associated with these conditions. Keywords Case report • Acute kidney injury • COVID-19 • Pediatric • Rhabdomyolysis • CRRTPublisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.