Rhabdomyolysis in Critically Ill Patients With COVID-19: A Retrospective Study.

INTRODUCTION: The total number of ICU admissions for COVID-19 patients has increased steadily. Based on the research team's clinical observations, many patients developed rhabdomyolysis, but few cases were reported in the literature. This study explores the incidence of rhabdomyolysis and its outcomes, like mortality, the need for intubation, acute kidney injury, and the need for renal replacement therapy (RRT). METHODS: We retrospectively reviewed the characteristics and outcomes of patients admitted to the ICU at a COVID-19-designated hospital in Qatar between March and July 2020. Logistic regression analysis was used to determine factors associated with mortality. RESULTS: 1079 patients with COVID-19 were admitted to the ICU, and 146 developed rhabdomyolysis. Overall, 30.1% died (n = 44), and 40.4% developed Acute Kidney Injury (AKI) (n = 59), with only 19 cases (13%) recovering from the AKI. AKI was significantly associated with increased mortality rates among rhabdomyolysis patients. Moreover, significant differences were found between groups regarding the subject's age, calcium level, phosphorus level, and urine output. However, the AKI was the best predictor of mortality for those who got the COVID-19 infection and rhabdomyolysis. CONCLUSION: Rhabdomyolysis increases the risk of death in COVID-19 patients admitted to the ICU. The strongest predictor of a fatal outcome was acute kidney injury. The findings of this study emphasize the importance of early identification and prompt treatment of rhabdomyolysis in patients with severe COVID-19.

Adipsic Hypernatremia With Neurologic Manifestations in a Patient With Severe COVID-19 Pneumonia.

This report describes a case of a 50-year-old man with hypertension who was admitted with a history of fever, chills, and shortness of breath and tested positive for COVID-19. Shortly after resolving his acute respiratory distress syndrome (ARDS), he developed adipsic hypernatremia with associated confusion, lethargy, and weakness. COVID-19 is a serious disease that mainly targets the respiratory system; however, we must not overlook its effects on other organ systems. When the etiology of hypernatremia is unclear, it requires extensive workup and monitoring, and the lack of rapid correction can cause serious and irreversible neurological damage.