COVID-19 infection and severe rhabdomyolysis

Abstract

Although patients with COVID-19 can have mild nonspecific myalgia and mild elevation of creatinine kinase levels, severe myalgia along with elevation of creatinine kinase levels >10 times the upper normal limit and dark-colored urine indicate an underlying severe rhabdomyolysis. This report describes a 60-year-old morbidly obese man who was found to have severe rhabdomyolysis, along with acute kidney injury, dark-colored urine, and a positive COVID-19 test. He had a prolonged hospital course requiring continuous renal replacement therapy, mechanical ventilation, and multiple vasopressors and eventually died of multiorgan failure. The management of severe rhabdomyolysis and COVID-19 is challenging, and fluid resuscitation should be done cautiously, monitoring for early signs of fluid overload.