Necrotizing autoimmune myositis following coronavirus disease 2019 infection: a case report

Abstract

Background Severe acute respiratory syndrome coronavirus 2 may be associated with late-onset necrotizing myositis, mimicking autoimmune inflammatory myositis; however, the exact underlying pathogenesis of severe acute respiratory syndrome coronavirus 2-induced myositis is still unclear. Case Presentation Herein, we report a rare case of necrotizing autoimmune myositis in a 67-year-old middle eastern male following coronavirus disease 2019 infection, who presented with muscle weakness. The patient had positive anti-NXP2. The diagnosis of necrotizing autoimmune myositis was made according to muscle weakness, increased liver enzymes, electromyography and nerve conduction velocity results, and muscle biopsy. The patient underwent a full malignancy evaluation, which was unremarkable, and was discharged in relatively well condition with a daily dose of 1 mg/kg prednisolone and azathioprine 150 mg (2 mg/kg). Conclusion Our report highlights the already known possible protracted sequence of coronavirus disease 2019 infection and the potential for delayed-onset necrotizing myositis.

Post-COVID exercise intolerance is associated with capillary alterations and immune dysregulations in skeletal muscles

“…Upper leg MRI also did not reveal signs of myositis, which is consistent with recently published radiological findings [51]. However, biopsies were taken almost a year after acute infection and several case reports of biopsy-proven myositis after SARS-CoV-2 have been published [52][53][54], and we ourselves histologically diagnosed non-specific myositis in some patients in the subacute aftermath of mild or moderate COVID (Additional file 1: Fig. S3F).…”

Post-COVID syndrome is associated with capillary alterations, macrophage infiltration and distinct transcriptomic signatures in skeletal muscles

“…Upper leg MRI also did not reveal signs of myositis, which is consistent with recently published radiological findings (50). However, biopsies were taken almost a year after acute infection and several case reports of biopsy-proven myositis after SARS-CoV-2 have been published (51)(52)(53), and we ourselves histologically diagnosed non-specific myositis in some patients in the subacute aftermath of mild or moderate COVID (Fig. S3F).…”

Increased rates of idiopathic inflammatory myopathies during the COVID-19 pandemic: a single-centre experience

“…Studies regarding SARS-CoV-2-induced IIM are lacking. Review of the literature yields mostly single case reports (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) , with larger case series referring to SARS-CoV-2 vaccines (21,22). Certainly, higher-level evidence is still required to discern whether the incidence of IIM has increased during the pandemic and whether the disease pattern and course have changed.…”