Karimi Mehdi, Faal Hamedanchi Neda, Ansari Kazem, Nahavandi Reza, Mazdak Mahsa, Javaherchian Fateme, Koochaki Pooneh, Asadi Anar Mahsa, Shirforoush Sattari Mahsa, Mohamaditabar Mona
Faculty of Medicine, Bogomolets National Medical University, Kyiv, Ukraine.
Faculty of Medicine, Islamic Azad University, Tehran Medical Sciences Branch, Tehran, Iran.
Front Med (Lausanne). 2024 Nov 20;11:1460676. doi: 10.3389/fmed.2024.1460676. eCollection 2024.
Rhabdomyolysis (RML), characterized by the breakdown of skeletal muscle fibers and the release of muscle contents into the bloodstream, has emerged as a notable complication associated with Coronavirus disease 2019 (COVID-19) infection and vaccination. Studies have reported an increased incidence of RML in individuals with severe COVID-19 infection. However, the exact mechanisms remain unclear and are believed to involve the host's immune response to the virus. Furthermore, RML has been documented as a rare adverse event following COVID-19 vaccination, particularly with mRNA vaccines. Proposed mechanisms include immune responses triggered by the vaccine and T-cell activation against viral spike proteins. This study aims to review the current literature on the incidence, pathophysiology, clinical presentation, and outcomes of RML secondary to COVID-19 infection and vaccination. We identify common risk factors and mechanisms underlying this condition by analyzing case reports, clinical studies, and pharmacovigilance data. Our findings suggest that while RML is a relatively rare adverse event, it warrants attention due to its potential severity and the widespread prevalence of COVID-19 and its vaccines. This review underscores the need for heightened clinical awareness and further research to optimize management strategies and improve patient outcomes in this context.
横纹肌溶解症(RML)的特征是骨骼肌纤维分解以及肌肉成分释放到血液中,它已成为与2019冠状病毒病(COVID-19)感染和疫苗接种相关的一种显著并发症。研究报告称,严重COVID-19感染患者中RML的发病率有所增加。然而,确切机制仍不清楚,据信与宿主对病毒的免疫反应有关。此外,RML已被记录为COVID-19疫苗接种后的一种罕见不良事件,尤其是mRNA疫苗。提出的机制包括疫苗引发的免疫反应以及针对病毒刺突蛋白的T细胞激活。本研究旨在综述关于COVID-19感染和疫苗接种继发RML的发病率、病理生理学、临床表现及预后的当前文献。我们通过分析病例报告、临床研究和药物警戒数据,确定了这种情况的常见危险因素和潜在机制。我们的研究结果表明,虽然RML是一种相对罕见的不良事件,但由于其潜在的严重性以及COVID-19及其疫苗的广泛流行,它值得关注。本综述强调需要提高临床认识并进一步开展研究,以优化管理策略并改善这一情况下的患者预后。