Rhabdomyolysis as the Initial Presentation of SARS-CoV-2 in an Adolescent

Abstract

The novel coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has created a global pandemic, with many cases affecting the elderly. However, children have been affected as well, with about 2.4-3.7% of cases reported. This case is the first published case of an adolescent presenting with rhabdomyolysis as the first sign of COVID-19, with extremely elevated creatinine kinase (CK) levels, approaching almost 400,000 U/L. This case adds to the growing body of literature of a variety of life-threatening manifestations associated with SARS-CoV-2 infection, and highlights the importance of how prompt recognition of these unique presentations of the disease is important to mitigate complications.

A Comprehensive Review of Neuromuscular Manifestations of COVID-19 and Management of Pre-Existing Neuromuscular Disorders in Children

“…There have been numerous reports of COVID-19-associated rhabdomyolysis in pediatric patients [14,[20][21][22][23][24][25][26][27][28][29] leading to acute kidney injury or acute renal failure [20,23,[27][28][29]. In some cases, rhabdomyolysis was the presenting symptom [26,29]. Both myositis and rhabdomyolysis may occur as a part of MIS-C [22,30].…”

COVID‐19‐associated rhabdomyolysis in a paediatric patient with sickle cell trait

“…3 The few case reports of COVID-19-associated rhabdomyolysis in children have been in adolescents, with significantly elevated CK (although the highest previously reported was 400 000 U/L, substantially less than this case). 4,5 All were febrile and had myalgia, a majority had cough and/or dyspnoea and one, a 16-year-old male with no co-morbidities, died. Management for all was supportive with fluids, diuresis and correction of electrolyte anomalies.…”

Neuropathological Aspects of SARS-CoV-2 Infection: Significance for Both Alzheimer’s and Parkinson’s Disease

“…There are reports of COVID-19 exerting neurological effects, the most common being hypogeusia (diminished sense of taste) and anosmia (loss of sense of smell) ( Gilani et al, 2020 ; Spudich and Nath, 2022 ), and cerebrovascular damage ( Beyrouti et al, 2020 ; Meegada et al, 2020 ; Gilpin et al, 2021 ). However, encephalopathies ( Helms et al, 2020 ), demyelination ( Domingues et al, 2020 ; Zanin et al, 2020 ), edema and symptom presentations similar to multiple sclerosis and Guillain-Barré have also been observed with COVID-19 ( Toscano et al, 2020 ; Spudich and Nath, 2022 ).…”