Relationship Between Rhabdomyolysis and SARS-CoV-2 Disease Severity
Background Rhabdomyolysis has historically been associated with viral infections, of which influenza A is the most common. A literature review suggests that up to 1/3 of patients hospitalized with COVID-19 develop acute kidney injury (AKI), and of those, nearly half are admitted to the ICU. AKI comp...
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| creator | Samardzic, Tijana Muradashvili, Tinatin Guirguis, Suzy Felek, Suleyman Pan, Samuel C Tiyyagura, Sandeep Feinn, Richard |
| description | Background Rhabdomyolysis has historically been associated with viral infections, of which influenza A is the most common. A literature review suggests that up to 1/3 of patients hospitalized with COVID-19 develop acute kidney injury (AKI), and of those, nearly half are admitted to the ICU. AKI complicating COVID-19 infection is attributed to several pathogeneses, including sepsis, direct cytopathic effects on the kidneys, and rhabdomyolysis. Objective We aimed to link COVID-19 infection to the development of rhabdomyolysis via creatine kinase (CK) measurement to assess whether this association increases ICU admission, length of stay (LOS), and mortality. Design and setting In this single-center, retrospective cohort study, we enrolled 984 adult patients with confirmed COVID-19 infection requiring admission to a community hospital between March 2020 and May 2021. Measurements Demographic data, laboratory values, and clinical outcomes were collected. The primary outcome measured was the development of rhabdomyolysis and/or AKI. Secondary outcomes included associations of rhabdomyolysis with ICU admission, length of hospital stay, and mortality, utilizing multivariable logistic regression methods. Results Out of the 984 patients included, 39 met the clinical criteria for rhabdomyolysis (4%). The incidence of rhabdomyolysis was higher in patients with AKI (38.3%) and in those who required ICU admission (53.8%) (p |
| doi_str_mv | 10.7759/cureus.53029 |
| format | Article |
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A literature review suggests that up to 1/3 of patients hospitalized with COVID-19 develop acute kidney injury (AKI), and of those, nearly half are admitted to the ICU. AKI complicating COVID-19 infection is attributed to several pathogeneses, including sepsis, direct cytopathic effects on the kidneys, and rhabdomyolysis. Objective We aimed to link COVID-19 infection to the development of rhabdomyolysis via creatine kinase (CK) measurement to assess whether this association increases ICU admission, length of stay (LOS), and mortality. Design and setting In this single-center, retrospective cohort study, we enrolled 984 adult patients with confirmed COVID-19 infection requiring admission to a community hospital between March 2020 and May 2021. Measurements Demographic data, laboratory values, and clinical outcomes were collected. The primary outcome measured was the development of rhabdomyolysis and/or AKI. Secondary outcomes included associations of rhabdomyolysis with ICU admission, length of hospital stay, and mortality, utilizing multivariable logistic regression methods. Results Out of the 984 patients included, 39 met the clinical criteria for rhabdomyolysis (4%). The incidence of rhabdomyolysis was higher in patients with AKI (38.3%) and in those who required ICU admission (53.8%) (p<0.001). There was an insignificant difference in death in this cohort (11 patients, 52.4%, p=0.996). However, the mean LOS in patients who had rhabdomyolysis was 18.2 days versus 9.8 days in patients who did not develop rhabdomyolysis (p<0.001). Conclusion Objectively tracking CK levels in COVID-19-infected patients can assist in diagnosing rhabdomyolysis, identifying AKI etiology, and accordingly making a preliminary prognosis for COVID-19 infection, which could direct physicians to initiate more intensive treatment earlier.</description><identifier>ISSN: 2168-8184</identifier><identifier>EISSN: 2168-8184</identifier><identifier>DOI: 10.7759/cureus.53029</identifier><identifier>PMID: 38410346</identifier><language>eng</language><publisher>United States: Cureus Inc</publisher><subject>Body mass index ; Case reports ; COVID-19 ; Cytokines ; Dehydrogenases ; Demographics ; Diabetes ; Infections ; Infectious Disease ; Intensive care ; Internal Medicine ; Kidney diseases ; Kinases ; Length of stay ; Mortality ; Musculoskeletal system ; Pandemics ; Rhabdomyolysis ; Severe acute respiratory syndrome coronavirus 2 ; Viral infections</subject><ispartof>Curēus (Palo Alto, CA), 2024-01, Vol.16 (1), p.e53029-e53029</ispartof><rights>Copyright © 2024, Samardzic et al.</rights><rights>Copyright © 2024, Samardzic et al. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright © 2024, Samardzic et al. 2024 Samardzic et al.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c343t-5f2c4b2815ea4e3922e353b9a16bbe89111f825e583f31a1afbdeafc368e38653</citedby><cites>FETCH-LOGICAL-c343t-5f2c4b2815ea4e3922e353b9a16bbe89111f825e583f31a1afbdeafc368e38653</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10895313/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10895313/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38410346$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Samardzic, Tijana</creatorcontrib><creatorcontrib>Muradashvili, Tinatin</creatorcontrib><creatorcontrib>Guirguis, Suzy</creatorcontrib><creatorcontrib>Felek, Suleyman</creatorcontrib><creatorcontrib>Pan, Samuel C</creatorcontrib><creatorcontrib>Tiyyagura, Sandeep</creatorcontrib><creatorcontrib>Feinn, Richard</creatorcontrib><title>Relationship Between Rhabdomyolysis and SARS-CoV-2 Disease Severity</title><title>Curēus (Palo Alto, CA)</title><addtitle>Cureus</addtitle><description>Background Rhabdomyolysis has historically been associated with viral infections, of which influenza A is the most common. A literature review suggests that up to 1/3 of patients hospitalized with COVID-19 develop acute kidney injury (AKI), and of those, nearly half are admitted to the ICU. AKI complicating COVID-19 infection is attributed to several pathogeneses, including sepsis, direct cytopathic effects on the kidneys, and rhabdomyolysis. Objective We aimed to link COVID-19 infection to the development of rhabdomyolysis via creatine kinase (CK) measurement to assess whether this association increases ICU admission, length of stay (LOS), and mortality. Design and setting In this single-center, retrospective cohort study, we enrolled 984 adult patients with confirmed COVID-19 infection requiring admission to a community hospital between March 2020 and May 2021. Measurements Demographic data, laboratory values, and clinical outcomes were collected. The primary outcome measured was the development of rhabdomyolysis and/or AKI. Secondary outcomes included associations of rhabdomyolysis with ICU admission, length of hospital stay, and mortality, utilizing multivariable logistic regression methods. Results Out of the 984 patients included, 39 met the clinical criteria for rhabdomyolysis (4%). The incidence of rhabdomyolysis was higher in patients with AKI (38.3%) and in those who required ICU admission (53.8%) (p<0.001). There was an insignificant difference in death in this cohort (11 patients, 52.4%, p=0.996). However, the mean LOS in patients who had rhabdomyolysis was 18.2 days versus 9.8 days in patients who did not develop rhabdomyolysis (p<0.001). Conclusion Objectively tracking CK levels in COVID-19-infected patients can assist in diagnosing rhabdomyolysis, identifying AKI etiology, and accordingly making a preliminary prognosis for COVID-19 infection, which could direct physicians to initiate more intensive treatment earlier.</description><subject>Body mass index</subject><subject>Case reports</subject><subject>COVID-19</subject><subject>Cytokines</subject><subject>Dehydrogenases</subject><subject>Demographics</subject><subject>Diabetes</subject><subject>Infections</subject><subject>Infectious Disease</subject><subject>Intensive care</subject><subject>Internal Medicine</subject><subject>Kidney diseases</subject><subject>Kinases</subject><subject>Length of stay</subject><subject>Mortality</subject><subject>Musculoskeletal system</subject><subject>Pandemics</subject><subject>Rhabdomyolysis</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Viral infections</subject><issn>2168-8184</issn><issn>2168-8184</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkU1Lw0AQhhdRrFRvniXgxYPRnZ1sujmJ1k8QhFa9Lpt0YlfSbN1NKv33tlZL9TQD8_AyLw9jh8DPej2ZnRetpzacSeQi22J7AlIVK1DJ9sbeYQchvHPOgfcE7_Fd1kGVAMck3WP9AVWmsa4OYzuNrqj5JKqjwdjkIzeZu2oebIhMPYqGl4Nh3HevsYiubSATKBrSjLxt5vtspzRVoIOf2WUvtzfP_fv48enuoX_5GBeYYBPLUhRJLhRIMglhJgShxDwzkOY5qQwASiUkSYUlggFT5iMyZYGpIlSpxC67WOVO23xCo4LqxptKT72dGD_Xzlj991LbsX5zMw1cZRIBFwknPwnefbQUGj2xoaCqMjW5NmiRoUgQlViix__Qd9f6etFvSWECyCFbUKcrqvAuBE_l-hvgemlIrwzpb0ML_GizwRr-9YFf_cuMnQ</recordid><startdate>20240127</startdate><enddate>20240127</enddate><creator>Samardzic, Tijana</creator><creator>Muradashvili, Tinatin</creator><creator>Guirguis, Suzy</creator><creator>Felek, Suleyman</creator><creator>Pan, Samuel C</creator><creator>Tiyyagura, Sandeep</creator><creator>Feinn, Richard</creator><general>Cureus Inc</general><general>Cureus</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>COVID</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20240127</creationdate><title>Relationship Between Rhabdomyolysis and SARS-CoV-2 Disease Severity</title><author>Samardzic, Tijana ; Muradashvili, Tinatin ; Guirguis, Suzy ; Felek, Suleyman ; Pan, Samuel C ; Tiyyagura, Sandeep ; Feinn, Richard</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c343t-5f2c4b2815ea4e3922e353b9a16bbe89111f825e583f31a1afbdeafc368e38653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Body mass index</topic><topic>Case reports</topic><topic>COVID-19</topic><topic>Cytokines</topic><topic>Dehydrogenases</topic><topic>Demographics</topic><topic>Diabetes</topic><topic>Infections</topic><topic>Infectious Disease</topic><topic>Intensive care</topic><topic>Internal Medicine</topic><topic>Kidney diseases</topic><topic>Kinases</topic><topic>Length of stay</topic><topic>Mortality</topic><topic>Musculoskeletal system</topic><topic>Pandemics</topic><topic>Rhabdomyolysis</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>Viral infections</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Samardzic, Tijana</creatorcontrib><creatorcontrib>Muradashvili, Tinatin</creatorcontrib><creatorcontrib>Guirguis, Suzy</creatorcontrib><creatorcontrib>Felek, Suleyman</creatorcontrib><creatorcontrib>Pan, Samuel C</creatorcontrib><creatorcontrib>Tiyyagura, Sandeep</creatorcontrib><creatorcontrib>Feinn, Richard</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Coronavirus Research Database</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Curēus (Palo Alto, CA)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Samardzic, Tijana</au><au>Muradashvili, Tinatin</au><au>Guirguis, Suzy</au><au>Felek, Suleyman</au><au>Pan, Samuel C</au><au>Tiyyagura, Sandeep</au><au>Feinn, Richard</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relationship Between Rhabdomyolysis and SARS-CoV-2 Disease Severity</atitle><jtitle>Curēus (Palo Alto, CA)</jtitle><addtitle>Cureus</addtitle><date>2024-01-27</date><risdate>2024</risdate><volume>16</volume><issue>1</issue><spage>e53029</spage><epage>e53029</epage><pages>e53029-e53029</pages><issn>2168-8184</issn><eissn>2168-8184</eissn><abstract>Background Rhabdomyolysis has historically been associated with viral infections, of which influenza A is the most common. A literature review suggests that up to 1/3 of patients hospitalized with COVID-19 develop acute kidney injury (AKI), and of those, nearly half are admitted to the ICU. AKI complicating COVID-19 infection is attributed to several pathogeneses, including sepsis, direct cytopathic effects on the kidneys, and rhabdomyolysis. Objective We aimed to link COVID-19 infection to the development of rhabdomyolysis via creatine kinase (CK) measurement to assess whether this association increases ICU admission, length of stay (LOS), and mortality. Design and setting In this single-center, retrospective cohort study, we enrolled 984 adult patients with confirmed COVID-19 infection requiring admission to a community hospital between March 2020 and May 2021. Measurements Demographic data, laboratory values, and clinical outcomes were collected. The primary outcome measured was the development of rhabdomyolysis and/or AKI. Secondary outcomes included associations of rhabdomyolysis with ICU admission, length of hospital stay, and mortality, utilizing multivariable logistic regression methods. Results Out of the 984 patients included, 39 met the clinical criteria for rhabdomyolysis (4%). The incidence of rhabdomyolysis was higher in patients with AKI (38.3%) and in those who required ICU admission (53.8%) (p<0.001). There was an insignificant difference in death in this cohort (11 patients, 52.4%, p=0.996). However, the mean LOS in patients who had rhabdomyolysis was 18.2 days versus 9.8 days in patients who did not develop rhabdomyolysis (p<0.001). Conclusion Objectively tracking CK levels in COVID-19-infected patients can assist in diagnosing rhabdomyolysis, identifying AKI etiology, and accordingly making a preliminary prognosis for COVID-19 infection, which could direct physicians to initiate more intensive treatment earlier.</abstract><cop>United States</cop><pub>Cureus Inc</pub><pmid>38410346</pmid><doi>10.7759/cureus.53029</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Body mass index Case reports COVID-19 Cytokines Dehydrogenases Demographics Diabetes Infections Infectious Disease Intensive care Internal Medicine Kidney diseases Kinases Length of stay Mortality Musculoskeletal system Pandemics Rhabdomyolysis Severe acute respiratory syndrome coronavirus 2 Viral infections |
| title | Relationship Between Rhabdomyolysis and SARS-CoV-2 Disease Severity |
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