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在一例罕见的继发于新型冠状病毒肺炎的严重横纹肌溶解症中进行大量静脉输液治疗

Liberal Intravenous Fluid Administration in a Rare Case of Severe Rhabdomyolysis Secondary to SARS-CoV-2.

作者信息

Fadel Celine, Phan Ngoc, Kaur Aman

机构信息

Internal Medicine, Northeast Georgia Medical Center Gainsville, Gainesville, USA.

出版信息

Cureus. 2021 Aug 16;13(8):e17234. doi: 10.7759/cureus.17234. eCollection 2021 Aug.

DOI:10.7759/cureus.17234
PMID:34540461
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8443426/
Abstract

SARS-CoV-2 entered the world by storm when it made its appearance at the end of 2019 in Wuhan, China. The severity can range from asymptomatic infection, which occurs in approximately 33% of infected patients, to death. Worldwide deaths due to SARS-CoV-2 are currently approximated at 3.8 million people with close to 600,000 deaths in the United States alone, reiterating the significant impact this virus has on the population. SARS-CoV-2 can affect systems of the body such as respiratory, gastrointestinal tract, neurological, cardiac, renal, and even skeletal muscle tissue. A few cases of rhabdomyolysis are reported in SARS-CoV-2 infection, but the significant level of creatinine kinase in the hundreds of thousands is rare. Our case demonstrates the rarity of SARS-CoV-2 manifestation in a 33-year-old African American male with severe rhabdomyolysis with a creatinine kinase on the admission of 362,445 IU/L. The patient was treated aggressively with intravenous fluids, monitoring electrolytes, renal function, and respiratory status closely. His management includes liberal administration of fluid to treat his rhabdomyolysis, without compromising his respiratory status. He was subsequently discharged home after seven days of hospitalization. We strive to share this information in hopes to share our management for future similar cases.

摘要

2019年底,严重急性呼吸综合征冠状病毒2(SARS-CoV-2)在中国武汉出现,席卷全球。其严重程度从无症状感染(约33%的感染患者会出现)到死亡不等。目前,全球因SARS-CoV-2死亡的人数约为380万,仅美国就有近60万人死亡,这再次凸显了这种病毒对人类的重大影响。SARS-CoV-2可影响人体的多个系统,如呼吸系统、胃肠道、神经系统、心脏、肾脏,甚至骨骼肌组织。有报道称SARS-CoV-2感染会出现几例横纹肌溶解症,但肌酸激酶水平高达数十万的情况较为罕见。我们的病例展示了一名33岁非裔美国男性感染SARS-CoV-2后出现严重横纹肌溶解症的罕见情况,其入院时肌酸激酶水平为362445 IU/L。该患者接受了积极的静脉补液治疗,并密切监测电解质、肾功能和呼吸状况。他的治疗包括大量补液以治疗横纹肌溶解症,同时不影响其呼吸状况。住院七天后,他随后出院回家。我们努力分享这些信息,希望能为未来类似病例提供我们的治疗经验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d647/8443426/119e6c935368/cureus-0013-00000017234-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d647/8443426/744ea26e441a/cureus-0013-00000017234-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d647/8443426/697f7757aad8/cureus-0013-00000017234-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d647/8443426/119e6c935368/cureus-0013-00000017234-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d647/8443426/744ea26e441a/cureus-0013-00000017234-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d647/8443426/697f7757aad8/cureus-0013-00000017234-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d647/8443426/119e6c935368/cureus-0013-00000017234-i03.jpg

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