Skeletal muscle damage in the course of coronavirus disease (COVID-19) in a pediatric practice. Own supervision: a clinical case

Authors

  • V.O. Svystilnyk Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine, Ukraine
  • O.S. Mihnusheva Kyiv City Pediatric Clinical Hospital 1, Kyiv, Ukraine, Ukraine
  • K.B. Savinova Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine, Ukraine

DOI:

https://doi.org/10.22141/2224-0713.17.7.2021.245559

Keywords:

SARS-CoV-2, COVID-19, coronavirus disease, ske-letal muscle damage, rhabdomyolysis

Abstract

Background. Coronavirus disease (COVID-19) pandemic is still at the heart of healthcare in Ukraine and over the world. The nervous system and other human organs and systems can be affected by pathogenic nature of SARS-CoV-2. We purposed to pay physicians’ attention to the diagnosis of skeletal muscle damage, in particular rhabdomyolysis, to avoid possible complications in COVID-19. Materials and methods. We have examined a group of children with skeletal muscle damage on the background of
COVID-19 during 2020–2021. A clinical case from own practice has been presented in the article. Results and conclusions. The patient, a 15-year-old boy, developed general weakness, severe pain in the right thigh and hip joint, fever 33 days after the acute phase of coronavirus disease. The differential diagnosis was carried out between skeletal muscle damage and osteomyelitis. Diffuse connective tissue diseases, oncohematological disorders, and hepatitis were excluded on the basis of clinical data and examinations. The inflammatory changes in m.iliopsoas, m.obturatorius internus and m.piriformis with abscess formation identified during clinical examination and magnetic resonance imaging, along with high levels of blood transaminases indicated the development of rhabdomyolysis. The detected positive IgG to SARS-CoV-2 confirmed the association of this pathological condition with the previous acute phase of COVID-19. Signs of coagulopathy, anemia in the hemogram simultaneously with the clinical symptoms of rhabdomyolysis confirmed the systemic lesions in the course of coronavirus disease in the child. Timely assessment of clinical symptoms (general weakness, muscle pain) and levels of creatine phosphokinase, transaminases, electrolytes, creatinine, blood urea will help make an early diagnosis of rhabdomyolysis, prescribe adequate therapy and prevent the deve-lopment of severe complications.

References

World Health Organization [internet]. 2020; https: //www.who.int/emergencies/diseases/novel- coronavirus-2019. Accessed March 11.2020.

Пилипенко В.М. Нейроендокринні порушення при COVID-19 і постковідному синдромі й особливості їх лікування препаратами гамма-аміномасляної кислоти. Міжнародний неврологічний журнал. 2021. Т. 17. № 1. С. 25-35.

Borges Do Nascimento I.J., Cacic N., Abdulazeem H.M. et al. Novel Coronovirus infection (COVID-19) in humans: a scoping review and meta-analysis. J. Clin. Med. 2020. 9. 941.

Portela-Sanchez S., Rodriguez Lopez A., Massot-Tarrus A., Catalina I. et al. Neurological complications of COVID-19 in hospitalized patients: The registry of a neurology department in the first wave of the pandemic. Eur. J. Neurol. 2021. 28. 3339-3347. doi: 10.1111/ene.14748.

Ellul M.A. et al. Neurological association of COVID-19. Lancet Neurol. 2020. doi: 10.1016/S1474-4422(20)30221-0.

Pinzon R.T., Wijaya V.O., Buana R.B. et al. Neurological characteristics in Coronavirus disease 2019 (COVID-19): a systematic review and meta-analysis. Front. Neurol. 2020. 11. 565. doi: 10.3389/fneur.2020.00565.

Wu Y., Xu X., Chen Z. et al. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behav. Immun. 2020. 87. 18-22. doi: 10.1016/j.bbi.2020.03.031.

Zubair A.S., McAlpine L.S., Gardin T., Farhadian S. et al. Нейропатогенез и неврологические проявления воздействия коронавирусов в эпоху коронавирусной болезни 2019. Международный неврологический журнал. 2020. T. 16. № 4. С. 115-124.

Дзяк Л.А., Цуркаленко О.С., Чеха К.В., Сук В.М. Сучасні аспекти нейропатогенезу й неврологічних проявів COVID-19. Міжнародний неврологічний журнал. 2021. Т. 17. № 2. С. 8-18. doi: 10.22141/2224-0713.17.2.2021.229887.

Fartushna O.Ye., Palahuta H.V., Yevtushenko S.K. Neurological and neuropsychiatric manifestations and complications of SARS-CoV-2 infection: a narrative review and a case presentation in a previously healthy young white adult. International Neurological Journal. 2021. T. 17. № 1. P. 36-41. doi: 10.22141/2224-0713.17.1.2021.226914.

Sudre C.H., Murray D., Varsavsky T. et al. Attributes and predictors of Long-Covid: analysis of COVID cases and their symptoms collected by the COVID Symptoms Study App. medRxiv.2020. doi: org/10.1101/2020.10.19.20214494.

Sreenath Meegada, Vijayadershan Muppidi, Donald C Wilkinson, Suman Siddamreddy, Shravan K. Katta. Coronavirus Disease 2019 — Induced Rhabdomyolysis. Cureus. 2020. 12(8). e10123. doi: 10.7759/cureus.10123.

Renata Siciliani Scalco, Alice Gardiner, Robert D.S. Pitceathly et al. Rhabdomyolysis: a genetic perspective. Orphanet Journal of Rare Diseases. 2015. 10. 51. doi: 10.1186/s13023-015-0264-3.

Lalani S.R., Liu P., Rosenfeld J.A., Watkin L.B., Chiang T. et al. Recurrent Muscle Weakness with Rhabdomyolysis. Metabolic Crises and Cardiac Arrhythmia Due to Bi-allelic TANGO2 Mutations. Am. J. Hum. Genet. 2016. 98(2). 347-57.

Min Jin, Qiaoxia Tong. Rhabdomyolysis as Potential Late Complication Associated with COVID-19. Emerg. Infect. Dis. 2020. 26(7). 1618-1620. doi: 10.3201/eid2607.200445.

Solis J.G., Pineda A.E., Minutti P.A., Sanchez. Case Report: Rhabdomyolysis in a Patient with COVID-19: A Proposed Diagnostic — Therapeutic Algorithm. Am. J. Trop. Med. Hyg. 2020. 103(3). 1158-1161. doi: 10.4269/ajtmh.20-0692.

McMahon G.M., Zeng X., Waikar S.S. A risk prediction score for kidney failure or mortality in rhabdomyolysis. JAMA Intern. Med. 2013. 173(19). 1821-8. doi: 10.1001/jamainternmed.2013.9774.

Simpson J.P., Taylor A., Sudhan N., Menon et al. Rhabdomyolysis and acute kidney injury: creatine kinase as a prognostic marker and validation of the McMahon Score in a 10-year cohort: A retrospective observational evaluation. Eur. J. Anaesthesiol. 2016. 33(12). 906-912. doi: 10.1097/EJA.0000000000000490.

Wakabayashi Y., Kikuno T., Ohwada T., Kikawada R. Rapid fall in blood myoglobin in massive rhabdomyolysis and acute renal fai-lure. Intensive Care Med. 1994. 20(2). 109-12.

Suwanwongse K., Shabarek N. Rhabdomyolysis as a Presentation of 2019 Novel Coronavirus Disease. Cureus. 2020. 12(4). e7561. doi: 10.7759/cureus.7561.

Published

2022-01-10

Issue

Section

Original Researches