Nashwan Abdulqadir J, Alassaf Anood, Abujaber Ahmad A, Al Wraidat Mohammad, Ananthegowda Dore C, Al-Kaabi Salma K, Othman Muftah, Ahmad Muayad K, Al Maslamani Muna, Khatib Mohamad
Nursing Department, Hamad Medical Corporation, Doha, QAT.
Pediatrics Department, Hamad Medical Corporation, Doha, QAT.
Cureus. 2023 Apr 9;15(4):e37333. doi: 10.7759/cureus.37333. eCollection 2023 Apr.
The total number of ICU admissions for COVID-19 patients has increased steadily. Based on the research team's clinical observations, many patients developed rhabdomyolysis, but few cases were reported in the literature. This study explores the incidence of rhabdomyolysis and its outcomes, like mortality, the need for intubation, acute kidney injury, and the need for renal replacement therapy (RRT).
We retrospectively reviewed the characteristics and outcomes of patients admitted to the ICU at a COVID-19-designated hospital in Qatar between March and July 2020. Logistic regression analysis was used to determine factors associated with mortality.
1079 patients with COVID-19 were admitted to the ICU, and 146 developed rhabdomyolysis. Overall, 30.1% died (n = 44), and 40.4% developed Acute Kidney Injury (AKI) (n = 59), with only 19 cases (13%) recovering from the AKI. AKI was significantly associated with increased mortality rates among rhabdomyolysis patients. Moreover, significant differences were found between groups regarding the subject's age, calcium level, phosphorus level, and urine output. However, the AKI was the best predictor of mortality for those who got the COVID-19 infection and rhabdomyolysis.
Rhabdomyolysis increases the risk of death in COVID-19 patients admitted to the ICU. The strongest predictor of a fatal outcome was acute kidney injury. The findings of this study emphasize the importance of early identification and prompt treatment of rhabdomyolysis in patients with severe COVID-19.
新冠病毒病（COVID-19）患者入住重症监护病房（ICU）的总数一直在稳步增加。基于研究团队的临床观察，许多患者出现了横纹肌溶解症，但文献报道的病例较少。本研究探讨横纹肌溶解症的发病率及其结局，如死亡率、插管需求、急性肾损伤以及肾脏替代治疗（RRT）需求。
我们回顾性分析了2020年3月至7月期间在卡塔尔一家COVID-19定点医院入住ICU的患者的特征和结局。采用逻辑回归分析来确定与死亡率相关的因素。
1079例COVID-19患者入住ICU，其中146例出现横纹肌溶解症。总体而言，30.1%（n = 44）死亡，40.4%（n = 59）发生急性肾损伤（AKI），只有19例（13%）从AKI中恢复。AKI与横纹肌溶解症患者死亡率增加显著相关。此外，在患者年龄、钙水平、磷水平和尿量方面，各组之间存在显著差异。然而，AKI是感染COVID-19并出现横纹肌溶解症患者死亡率的最佳预测指标。
横纹肌溶解症增加了入住ICU的COVID-19患者的死亡风险。致命结局的最强预测指标是急性肾损伤。本研究结果强调了对重症COVID-19患者早期识别和及时治疗横纹肌溶解症的重要性。
