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COVID-19 感染住院患者的横纹肌溶解症:五例病例系列。

Rhabdomyolysis in Patients Hospitalized With COVID-19 Infection: Five Case Series.

机构信息

Veterans Affairs Medical Center, Washington, DC, USA.

George Washington University, Washington, DC, USA.

出版信息

J Investig Med High Impact Case Rep. 2020 Jan-Dec;8:2324709620984603. doi: 10.1177/2324709620984603.

DOI:10.1177/2324709620984603
PMID:33371733
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7780065/
Abstract

The novel SARS-CoV-2 virus (severe acute respiratory syndrome coronavirus 2) is now known to cause acute respiratory distress, cytokine storm, and coagulopathy. Multiple other manifestations have been published in recent literature. Rhabdomyolysis is a syndrome of muscle damage, with release of intracellular contents into circulation. It is characterized by marked elevations of creatinine kinase levels and myoglobinuria. In this article, we describe a series of 5 cases who were admitted with COVID-19 pneumonia and had severe muscle injury, as demonstrated by significant elevation (>5 times upper limit of normal) of creatinine kinase levels likely secondary to SARS-CoV-2 virus. The median age for these patients was 65 years, and most of them suffered from diabetes and hyperlipidemia. All patients were hypertensive males. Four out of 5 patients had preserved kidney function at baseline and were chronic kidney disease (CKD) stage 2 or better. However, most of them suffered significant kidney injury and at the time of discharge one patient was CKD stage 2 or better, 2 were CKD stage 3 or worse, and 2 patients had renal failure and died due to complications of SARS-CoV-2 infection.

摘要

新型严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)现已被认为可引起急性呼吸窘迫、细胞因子风暴和凝血功能障碍。最近的文献中已经报道了多种其他表现。横纹肌溶解症是一种肌肉损伤综合征,其细胞内物质释放到循环中。其特征为肌酸激酶水平显著升高和肌红蛋白尿。在本文中,我们描述了一系列 5 例因 COVID-19 肺炎入院并伴有严重肌肉损伤的患者,其肌酸激酶水平显著升高(>正常值上限的 5 倍),可能继发于 SARS-CoV-2 病毒。这些患者的中位年龄为 65 岁,大多数患有糖尿病和高血脂症。所有患者均为高血压男性。5 例中有 4 例患者在基线时肾功能正常,为慢性肾脏病(CKD)2 期或以上。然而,他们中的大多数都遭受了严重的肾脏损伤,在出院时,1 例为 CKD 2 期或以上,2 例为 CKD 3 期或更差,2 例患者因 SARS-CoV-2 感染的并发症而出现肾衰竭并死亡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e570/7783881/b1fc99331af2/10.1177_2324709620984603-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e570/7783881/dc16aa416903/10.1177_2324709620984603-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e570/7783881/b1fc99331af2/10.1177_2324709620984603-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e570/7783881/dc16aa416903/10.1177_2324709620984603-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e570/7783881/b1fc99331af2/10.1177_2324709620984603-fig2.jpg

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Coagulopathy and Plausible Benefits of Anticoagulation Among COVID-19 Patients.新冠病毒感染患者的凝血病与抗凝治疗的可能获益。
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