Sotirios Kakavas, Vasiliki Nanou, Stamatoula Tsikrika, Alexia Alexikou, Nikolaos Magkas, Sylvia Raftopoulou
"Sotiria" Chest Diseases General Hospital Intensive Care Unit Center for Respiratory Failure Athens Greece.
J Acute Med. 2023 Jun 1;13(2):75-78. doi: 10.6705/j.jacme.202306_13(2).0004.
Rhabdomyolysis is an uncommon complication in patients with severe SARS CoV-2 infection. This report presents a case of rhabdomyolysis in a critically ill patient with acute respiratory distress syndrome owing to COVID-19. The clinical manifestations included fever, tea-colored urine because of myoglobinuria, and elevated serum creatine kinase (CK). Muscle weakness was present and hindered successful weaning from mechanical ventilation. Prompt and aggressive fluid resuscitation was initiated in combination with alkalization of urine and furosemide administration. Treatment was titrated to maintain an adequate urine output with excellent clinical response. Severe COVID-19 infection may be accompanied by the late occurrence of rhabdomyolysis. CK levels should be monitored regularly and patients should be treated promptly with the adequate expansion of the extracellular volume. In our case, the intensive treatment proved to be effective in preventing acute kidney injury and related metabolic complications.
横纹肌溶解症是重症严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染患者中不常见的并发症。本报告介绍了1例因2019冠状病毒病（COVID-19）导致急性呼吸窘迫综合征的危重症患者发生横纹肌溶解症的病例。临床表现包括发热、因肌红蛋白尿导致的茶色尿以及血清肌酸激酶（CK）升高。存在肌肉无力，阻碍了机械通气的成功撤机。立即开始迅速且积极的液体复苏，并联合尿液碱化及给予呋塞米。调整治疗以维持充足尿量，并获得了良好的临床反应。严重的COVID-19感染可能伴有横纹肌溶解症的迟发。应定期监测CK水平，患者应及时接受细胞外液量充分扩充的治疗。在我们的病例中，强化治疗被证明可有效预防急性肾损伤及相关代谢并发症。
