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新型冠状病毒肺炎(COVID-19)感染住院患者横纹肌溶解症的发病率、危险因素及结局

Incidence, Risk Factors, and Outcomes of Rhabdomyolysis in Hospitalized Patients With COVID-19 Infection.

作者信息

Albaba Isam, Chopra Amit, Al-Tarbsheh Ali H, Feustel Paul J, Mustafa Mohammed, Oweis Jozef, Parimi Sai Anoosh, Santelises Robledo Fabiana M, Mehta Swati

机构信息

Internal Medicine, Albany Medical Center, Albany, USA.

Department of Pulmonary and Critical Care Medicine, Albany Medical Center, Albany, USA.

出版信息

Cureus. 2021 Nov 22;13(11):e19802. doi: 10.7759/cureus.19802. eCollection 2021 Nov.

Abstract

INTRODUCTION

There is a paucity of studies examining the prevalence and clinical characteristics of rhabdomyolysis in hospitalized patients with COVID-19 infection. The purpose of this study is to examine the incidence, clinical characteristics, and outcome of hospitalized patients with COVID-19 infection who develop rhabdomyolysis.

METHODOLOGY

This is a single-center retrospective analysis of all hospitalized patients with COVID-19 admitted between March 8, 2020, and January 11, 2021. All patients with creatinine kinase (CK) levels available during the hospital admission were included. Rhabdomyolysis was defined as an elevation in CK level higher than five times the upper limit of normal (i.e., 1125 U/L). We compared clinical characteristics and outcomes of patients who developed rhabdomyolysis with patients who did not develop rhabdomyolysis.

RESULTS

The incidence of rhabdomyolysis in hospitalized patients with COVID-19 infection was 9.2%. There was no significant difference noted in comorbidities and clinical characteristics between the two groups. Moreover, there was no significant difference noted in the presence of severe COVID-19 infection (72.7% vs 54.6%, p = 0.1), mortality (27.3% vs 23.9%, p = 0.72), acute kidney injury (59.1% vs 42.7%, p = 0.14), or need for intensive care unit (ICU) care (72.7% vs 51.4%, p = 0.051). However, a higher percentage of patients in the rhabdomyolysis group required physical rehabilitation after discharge (40.9% vs 19.3%, p = 0.02).

CONCLUSION

The overall incidence of rhabdomyolysis in hospitalized patients with COVID-19 infection was high (9.2%). The presence of rhabdomyolysis was not associated with the increased severity of the disease. Patients with rhabdomyolysis more frequently required physical rehabilitation compared to those without rhabdomyolysis.

摘要

引言

关于新冠病毒感染住院患者横纹肌溶解症的患病率及临床特征的研究较少。本研究旨在探讨新冠病毒感染住院患者发生横纹肌溶解症的发病率、临床特征及预后。

方法

这是一项对2020年3月8日至2021年1月11日期间收治的所有新冠病毒感染住院患者进行的单中心回顾性分析。纳入所有住院期间有肌酐激酶(CK)水平数据的患者。横纹肌溶解症定义为CK水平升高超过正常上限的五倍(即1125 U/L)。我们比较了发生横纹肌溶解症的患者与未发生横纹肌溶解症的患者的临床特征及预后。

结果

新冠病毒感染住院患者横纹肌溶解症的发病率为9.2%。两组患者的合并症及临床特征无显著差异。此外,在重症新冠病毒感染(72.7%对54.6%,p = 0.1)、死亡率(27.3%对23.9%,p = 0.72)、急性肾损伤(59.1%对42.7%,p = 0.14)或入住重症监护病房(ICU)的需求(72.7%对51.4%,p = 0.051)方面也无显著差异。然而,横纹肌溶解症组出院后需要进行身体康复的患者比例更高(40.9%对19.3%,p = 0.02)。

结论

新冠病毒感染住院患者横纹肌溶解症的总体发病率较高(9.2%)。横纹肌溶解症的存在与疾病严重程度增加无关。与未发生横纹肌溶解症的患者相比,发生横纹肌溶解症的患者更频繁地需要进行身体康复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57e3/8693832/bd4a8a3265a4/cureus-0013-00000019802-i01.jpg

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