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以乏力和肌酸激酶升高为首发表现的 2019 冠状病毒病(COVID-19)。

Weakness and elevated creatinine kinase as the initial presentation of coronavirus disease 2019 (COVID-19).

机构信息

Department of Medical Education, Saint Michael's Medical Centre, New York Medical College, NJ, United States.

Department of Medical Education, Saint Michael's Medical Centre, New York Medical College, NJ, United States.

出版信息

Am J Emerg Med. 2020 Jul;38(7):1548.e1-1548.e3. doi: 10.1016/j.ajem.2020.05.015. Epub 2020 May 11.

Abstract

COVID-19 is a global public health emergency with more than one million positive cases across the globe. COVID-19 has a multifaceted presentation. We are herein to report two cases of SARS-CoV-2 induced rhabdomyolysis with an initial presentation of weakness and elevated creatinine kinase (CK). Both patients had no respiratory symptoms, they only complained of generalized weakness and were found to have elevated CK. Routine chest X-ray showed bilateral infiltrates in both cases and subsequently reverse-transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2 was positive. To the best of our knowledge, there was only one literature to date documented SARS-CoV-2 induced rhabdomyolysis as a late complication of COVID-19 patient. Our cases showed that elevated CK and rhabdomyolysis can be the sole initial presentation of patients with COVID-19 and total CK should be ordered in every patient on admission.

摘要

新型冠状病毒肺炎(COVID-19)是一种全球性的公共卫生紧急事件,目前全球已有超过 100 万例确诊病例。COVID-19 的表现形式多种多样。我们在此报告两例因严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)引起的横纹肌溶解症,其最初表现为虚弱和肌酸激酶(CK)升高。两名患者均无呼吸道症状,仅主诉全身无力,且 CK 升高。常规胸部 X 线检查显示两例均有双侧浸润影,随后 SARS-CoV-2 的逆转录聚合酶链反应(RT-PCR)检测为阳性。据我们所知,迄今为止,仅有一篇文献记录了 SARS-CoV-2 引起的横纹肌溶解症是 COVID-19 患者的晚期并发症。我们的病例表明,CK 升高和横纹肌溶解症可能是 COVID-19 患者的唯一初始表现,应在每位入院患者中常规检测总 CK。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae56/7211689/e51aaa8eb572/gr1_lrg.jpg

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