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A Case of Rhabdomyolysis in a Young, Morbidly Obese, Asthmatic Woman With COVID-19

COVID-19 is a respiratory disease that has been shown to have extrapulmonary manifestations. One association with COVID-19 is rhabdomyolysis, which is defined as the breakdown of skeletal muscles. There have been increasing reports of rhabdomyolysis in obese, middle-aged male COVID-19 patients, but...

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Autores principales: Mariano, Johnafaye, MacLaren, George A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9547668/
https://www.ncbi.nlm.nih.gov/pubmed/36237756
http://dx.doi.org/10.7759/cureus.28950
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author Mariano, Johnafaye
MacLaren, George A
author_facet Mariano, Johnafaye
MacLaren, George A
author_sort Mariano, Johnafaye
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description COVID-19 is a respiratory disease that has been shown to have extrapulmonary manifestations. One association with COVID-19 is rhabdomyolysis, which is defined as the breakdown of skeletal muscles. There have been increasing reports of rhabdomyolysis in obese, middle-aged male COVID-19 patients, but limited published cases affecting young adult females. This case discusses the early presentation of rhabdomyolysis in a young, morbidly obese, asthmatic woman with COVID-19. A 28-year-old, unvaccinated, African American female with past medical history of asthma, tobacco abuse, and a BMI of 46 initially presented to the emergency department with a complaint of fever, cough, and shortness of breath for two days. She was initially diagnosed with an asthma exacerbation and was treated symptomatically, but her symptoms persisted despite treatment. She began to experience myalgias the next day, followed by bilateral lower extremity weakness and dark urine two days later. Urinalysis revealed gross hematuria, 2-4 red blood cells per high-power field, 100 mg/dL protein, >8.0 mg/dL urobilinogen, and 0-2 hyaline casts. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), and creatine kinase (CK) levels were noted to be elevated. Her subsequent COVID-19 test was positive, and both blood and respiratory cultures were negative. She was diagnosed with rhabdomyolysis which was likely secondary to COVID-19. Her CK, ALT, and AST levels normalized after two weeks with the resolution of rhabdomyolysis, but she continued to have persistent COVID-19 infection and deteriorating respiratory status. She eventually required mechanical ventilation on day 20 and passed away on day 59 of hospitalization. Rhabdomyolysis is an infrequent finding that can be associated with COVID-19. It has been increasingly reported in middle-aged obese male patients but is far less common in younger females. The presence of elevated CK has been associated with higher mortality among COVID-19 patients, but current literature demonstrates that the majority of these patients are older males. It is imperative to recognize and treat rhabdomyolysis in all patients, particularly younger females, to help mitigate the comorbidities of COVID-19.
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spelling pubmed-95476682022-10-12 A Case of Rhabdomyolysis in a Young, Morbidly Obese, Asthmatic Woman With COVID-19 Mariano, Johnafaye MacLaren, George A Cureus Internal Medicine COVID-19 is a respiratory disease that has been shown to have extrapulmonary manifestations. One association with COVID-19 is rhabdomyolysis, which is defined as the breakdown of skeletal muscles. There have been increasing reports of rhabdomyolysis in obese, middle-aged male COVID-19 patients, but limited published cases affecting young adult females. This case discusses the early presentation of rhabdomyolysis in a young, morbidly obese, asthmatic woman with COVID-19. A 28-year-old, unvaccinated, African American female with past medical history of asthma, tobacco abuse, and a BMI of 46 initially presented to the emergency department with a complaint of fever, cough, and shortness of breath for two days. She was initially diagnosed with an asthma exacerbation and was treated symptomatically, but her symptoms persisted despite treatment. She began to experience myalgias the next day, followed by bilateral lower extremity weakness and dark urine two days later. Urinalysis revealed gross hematuria, 2-4 red blood cells per high-power field, 100 mg/dL protein, >8.0 mg/dL urobilinogen, and 0-2 hyaline casts. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), and creatine kinase (CK) levels were noted to be elevated. Her subsequent COVID-19 test was positive, and both blood and respiratory cultures were negative. She was diagnosed with rhabdomyolysis which was likely secondary to COVID-19. Her CK, ALT, and AST levels normalized after two weeks with the resolution of rhabdomyolysis, but she continued to have persistent COVID-19 infection and deteriorating respiratory status. She eventually required mechanical ventilation on day 20 and passed away on day 59 of hospitalization. Rhabdomyolysis is an infrequent finding that can be associated with COVID-19. It has been increasingly reported in middle-aged obese male patients but is far less common in younger females. The presence of elevated CK has been associated with higher mortality among COVID-19 patients, but current literature demonstrates that the majority of these patients are older males. It is imperative to recognize and treat rhabdomyolysis in all patients, particularly younger females, to help mitigate the comorbidities of COVID-19. Cureus 2022-09-08 /pmc/articles/PMC9547668/ /pubmed/36237756 http://dx.doi.org/10.7759/cureus.28950 Text en Copyright © 2022, Mariano et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Mariano, Johnafaye
MacLaren, George A
A Case of Rhabdomyolysis in a Young, Morbidly Obese, Asthmatic Woman With COVID-19
title A Case of Rhabdomyolysis in a Young, Morbidly Obese, Asthmatic Woman With COVID-19
title_full A Case of Rhabdomyolysis in a Young, Morbidly Obese, Asthmatic Woman With COVID-19
title_fullStr A Case of Rhabdomyolysis in a Young, Morbidly Obese, Asthmatic Woman With COVID-19
title_full_unstemmed A Case of Rhabdomyolysis in a Young, Morbidly Obese, Asthmatic Woman With COVID-19
title_short A Case of Rhabdomyolysis in a Young, Morbidly Obese, Asthmatic Woman With COVID-19
title_sort case of rhabdomyolysis in a young, morbidly obese, asthmatic woman with covid-19
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9547668/
https://www.ncbi.nlm.nih.gov/pubmed/36237756
http://dx.doi.org/10.7759/cureus.28950
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