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Severe acute myopathy following SARS-CoV-2 infection: a case report and review of recent literature.
Islam, Badrul; Ahmed, Mohiuddin; Islam, Zhahirul; Begum, S M.
  • Islam B; Laboratory Sciences and Services Division (LSSD), International Center for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh. badrul.islam@icddrb.org.
  • Ahmed M; Bangladesh Specialized Hospital, Dhaka, Bangladesh.
  • Islam Z; Laboratory Sciences and Services Division (LSSD), International Center for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
  • Begum SM; Bangladesh Specialized Hospital, Dhaka, Bangladesh.
Skelet Muscle ; 11(1): 10, 2021 04 21.
Article in English | MEDLINE | ID: covidwho-1197351
Semantic information from SemMedBD (by NLM)
1. Phosphotransferases ASSOCIATED_WITH Severe infection
Subject
Phosphotransferases
Predicate
ASSOCIATED_WITH
Object
Severe infection
2. Myositis CAUSES Myopathy
Subject
Myositis
Predicate
CAUSES
Object
Myopathy
3. Stress COEXISTS_WITH Pneumonia
Subject
Stress
Predicate
COEXISTS_WITH
Object
Pneumonia
4. Pneumonia CAUSES Respiratory Failure
Subject
Pneumonia
Predicate
CAUSES
Object
Respiratory Failure
5. Biological Markers PREDISPOSES Respiratory Failure
Subject
Biological Markers
Predicate
PREDISPOSES
Object
Respiratory Failure
6. Phosphotransferases ASSOCIATED_WITH Pneumonia
Subject
Phosphotransferases
Predicate
ASSOCIATED_WITH
Object
Pneumonia
7. Phosphotransferases ASSOCIATED_WITH Severe infection
Subject
Phosphotransferases
Predicate
ASSOCIATED_WITH
Object
Severe infection
8. Myositis CAUSES Myopathy
Subject
Myositis
Predicate
CAUSES
Object
Myopathy
9. Stress COEXISTS_WITH Pneumonia
Subject
Stress
Predicate
COEXISTS_WITH
Object
Pneumonia
10. Pneumonia CAUSES Respiratory Failure
Subject
Pneumonia
Predicate
CAUSES
Object
Respiratory Failure
11. Biological Markers PREDISPOSES Respiratory Failure
Subject
Biological Markers
Predicate
PREDISPOSES
Object
Respiratory Failure
12. Phosphotransferases ASSOCIATED_WITH Pneumonia
Subject
Phosphotransferases
Predicate
ASSOCIATED_WITH
Object
Pneumonia
ABSTRACT

BACKGROUND:

SARS-CoV2 virus could be potentially myopathic. Serum creatinine phosphokinase (CPK) is frequently found elevated in severe SARS-CoV2 infection, which indicates skeletal muscle damage precipitating limb weakness or even ventilatory failure. CASE PRESENTATION We addressed such a patient in his forties presented with features of severe SARS-CoV2 pneumonia and high serum CPK. He developed severe sepsis and acute respiratory distress syndrome (ARDS) and received intravenous high dose corticosteroid and tocilizumab to counter SARS-CoV2 associated cytokine surge. After 10 days of mechanical ventilation (MV), weaning was unsuccessful albeit apparently clear lung fields, having additionally severe and symmetric limb muscle weakness. Ancillary investigations in addition with serum CPK, including electromyogram, muscle biopsy, and muscle magnetic resonance imaging (MRI) suggested acute myopathy possibly due to skeletal myositis.

CONCLUSION:

We wish to stress that myopathogenic medication in SARS-CoV2 pneumonia should be used with caution. Additionally, serum CPK could be a potential marker to predict respiratory failure in SARS-CoV2 pneumonia as skeletal myopathy affecting chest muscles may contribute ventilatory failure on top of oxygenation failure due to SARS-CoV2 pneumonia.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Quadriplegia / Respiratory Distress Syndrome / Muscle, Skeletal / Creatine Kinase / COVID-19 / Muscular Diseases Type of study: Diagnostic study / Etiology study / Prognostic study Topics: Long Covid Language: English Journal: Skelet Muscle Year: 2021 Document Type: Article Affiliation country: S13395-021-00266-5

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Quadriplegia / Respiratory Distress Syndrome / Muscle, Skeletal / Creatine Kinase / COVID-19 / Muscular Diseases Type of study: Diagnostic study / Etiology study / Prognostic study Topics: Long Covid Language: English Journal: Skelet Muscle Year: 2021 Document Type: Article Affiliation country: S13395-021-00266-5