Coronavirus Disease 2019-Induced Rhabdomyolysis

Meegada, Sreenath; Muppidi, Vijayadershan; Wilkinson, Donald C; Siddamreddy, Suman; Katta, Shravan K

doi:10.7759/cureus.10123

Cited by 27 publications

(29 citation statements)

References 16 publications

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“…Rhabdomyolysis characterized by myalgia, fatigue, and hemoglobinuria has been described as a life-threatening syndrome in COVID-19 patients [161]. It has been ascribed as an early-late manifestation in COVID-19, which can lead to acute renal injury [113,161]. Several hypotheses exist regarding the pathogenic mechanism of muscle manifestations in COVID-19 patients.…”

Section: Skeletal Muscle Manifestationsmentioning

confidence: 99%

Emerging COVID-19 Neurological Manifestations: Present Outlook and Potential Neurological Challenges in COVID-19 Pandemic

et al. 2021

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The unremitting coronavirus disease 2019 (COVID-19) pandemic caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) marked a year-long phase of public health adversaries and has severely compromised healthcare globally. Early evidence of COVID-19 noted its impact on the pulmonary and cardiovascular functions, while multiple studies in recent time shed light on its substantial neurological complications, though a comprehensive understanding of the cause(s), the mechanism(s), and their neuropathological outcomes is scarce. In the present review, we conferred evidence of neurological complications in COVID-19 patients and shed light on the SARS-CoV-2 infection routes including the hematogenous, direct/neuronal, lymphatic tissue or cerebrospinal fluid, or infiltration through infected immune cells, while the underlying mechanism of SARS-CoV-2 invasion to the central nervous system (CNS) was also discussed. In an up-to-date manner, we further reviewed the impact of COVID-19 in developing diverse neurologic manifestations associated with CNS, peripheral nervous system (PNS), skeletal muscle, and also pre-existing neurological diseases, including Alzheimer's disease, Parkinson's disease, multiple sclerosis, epilepsy, and myasthenia gravis. Furthermore, we discussed the involvement of key factors including age, sex, comorbidity, and disease severity in exacerbating the neurologic manifestations in COVID-19 patients. An outlook of present therapeutic strategies and state of existing challenges in COVID-19 management was also accessed. Conclusively, the present report provides a comprehensive review of COVID-19-related neurological complications and emphasizes the need for their early clinical management in the ongoing COVID-19 pandemic. Keywords COVID-19 • SARS-CoV-2 • CNS • PNS • Neuroinvasion • COVID-19 pandemic • Neurological complications Highlights• Coronavirus disease 2019 (COVID-19)-associated complications involve substantial neurological manifestations.• SARS-CoV-2 infection routes include the hematogenous, neuronal, lymphatic tissue/cerebrospinal fluid, or infiltration through infected immune cells.• COVID-19 promotes neurologic manifestations associated with the central and peripheral nervous system and exacerbates the pre-existing neurological and neurodegenerative conditions. • Patient's age, sex, comorbidity, and severity of the infection are key factors that determine the extent of neurologic manifestations in COVID-19 patients.

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Section: Skeletal Muscle Manifestationsmentioning

confidence: 99%

Emerging COVID-19 Neurological Manifestations: Present Outlook and Potential Neurological Challenges in COVID-19 Pandemic

et al. 2021

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“…A case of COVID-19-associated myopathy caused by type I interferonopathy has been reported ( 174 ). Rhabdomyolysis has also been reported as an atypical presentation of COVID-19 ( 175 ): 20% of patients with severe respiratory disease and 5% with non-severe respiratory illness had evidence of skeletal muscle injury in a retrospective cohort of COVID-19 patients ( 167 ).…”

Section: Resultsmentioning

confidence: 99%

Neurologic Manifestations of the World Health Organization's List of Pandemic and Epidemic Diseases

et al. 2021

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The World Health Organization (WHO) monitors the spread of diseases globally and maintains a list of diseases with epidemic or pandemic potential. Currently listed diseases include Chikungunya, cholera, Crimean-Congo hemorrhagic fever, Ebola virus disease, Hendra virus infection, influenza, Lassa fever, Marburg virus disease, Neisseria meningitis, MERS-CoV, monkeypox, Nipah virus infection, novel coronavirus (COVID-19), plague, Rift Valley fever, SARS, smallpox, tularemia, yellow fever, and Zika virus disease. The associated pathogens are increasingly important on the global stage. The majority of these diseases have neurological manifestations. Those with less frequent neurological manifestations may also have important consequences. This is highlighted now in particular through the ongoing COVID-19 pandemic and reinforces that pathogens with the potential to spread rapidly and widely, in spite of concerted global efforts, may affect the nervous system. We searched the scientific literature, dating from 1934 to August 2020, to compile data on the cause, epidemiology, clinical presentation, neuroimaging features, and treatment of each of the diseases of epidemic or pandemic potential as viewed through a neurologist's lens. We included articles with an abstract or full text in English in this topical and scoping review. Diseases with epidemic and pandemic potential can be spread directly from human to human, animal to human, via mosquitoes or other insects, or via environmental contamination. Manifestations include central neurologic conditions (meningitis, encephalitis, intraparenchymal hemorrhage, seizures), peripheral and cranial nerve syndromes (sensory neuropathy, sensorineural hearing loss, ophthalmoplegia), post-infectious syndromes (acute inflammatory polyneuropathy), and congenital syndromes (fetal microcephaly), among others. Some diseases have not been well-characterized from a neurological standpoint, but all have at least scattered case reports of neurological features. Some of the diseases have curative treatments available while in other cases, supportive care remains the only management option. Regardless of the pathogen, prompt, and aggressive measures to control the spread of these agents are the most important factors in lowering the overall morbidity and mortality they can cause.

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“…This suggests COVID-19 to be the likely etiology as the other causes have been ruled out. There are cases that reported COVID-19 associated rhabdomyolysis in pediatric and young adults (18-35 years) (Table 1) [20][21][22][23][24][25]. The mechanism by which COVID-19 causes muscle damage is uncertain, but various mechanisms have been described for another viral myositis, including direct invasion of muscle tissue by the virus [9,13], immunologic processes induced by the virus that results in muscle damage, and the cytokine storm released in response to viral infection [9,26].…”

Section: Discussionmentioning

confidence: 99%

Asymptomatic Rhabdomyolysis in a Young Adult With COVID-19

Farouji¹,

Hellou²,

Peretz³

2021

Cureus

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The novel coronavirus disease 2019 (COVID-19) is an ongoing pandemic. Although COVID-19 is frequently associated with respiratory symptoms and complications, multiple extrapulmonary manifestations have been identified since the beginning of the pandemic. Rhabdomyolysis has been described in the literature as one of the extrapulmonary manifestations of COVID-19. Herein, we describe a 21-year-old male patient who presented with cough and fever secondary to COVID-19 confirmed by positive reverse-transcription polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The patient presented with an extremely elevated creatinine kinase (CK) of 53,886 U/L (normal 10-170) without any classical symptoms of rhabdomyolysis or deterioration in his kidney function. He was successfully managed with aggressive intravenous fluids. The aim of reporting this case is to highlight the importance of including total CK in the initial evaluation of COVID-19 patients.

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Coronavirus Disease 2019-Induced Rhabdomyolysis

Cited by 27 publications

References 16 publications

Emerging COVID-19 Neurological Manifestations: Present Outlook and Potential Neurological Challenges in COVID-19 Pandemic

Emerging COVID-19 Neurological Manifestations: Present Outlook and Potential Neurological Challenges in COVID-19 Pandemic

Neurologic Manifestations of the World Health Organization's List of Pandemic and Epidemic Diseases

Asymptomatic Rhabdomyolysis in a Young Adult With COVID-19

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