Rhabdomyolysis is Associated with Hospital Mortality in Patients with COVID-19 (preprint)

ABSTRACT

Purpose: To evaluate the clinical features and outcomes of rhabdomyolysis (RM) in patients with COVID-19. Method: A single center retrospective cohort study of 1,014 consecutive hospitalized patients with confirmed COVID-19 at the Huoshenshan hospital in Wuhan, China, between February 17 and April 12, 2020. Results: The overall incidence of RM was 2.2%. Comparing with patients without RM, patients with RM tended to have a higher risk of deterioration, representing by higher ratio to be admitted to the intensive care unit (ICU) (90.9 % vs 5.3%, P <0.001), and to undergo mechanical ventilation (86.4 % vs 2.7% P <0.001). Compared with patients without RM, patients with RM had laboratory test abnormalities, including indicators of inflammation, coagulation activation and kidney injury. Patients with RM had a higher risk of hospital death ( P < 0.001). Cox proportional hazard regression model confirmed that RM indicators, including peak creatine kinase (CK) >1000 IU/L (HR=6.46, 95% CI 3.02-13.86), peak serum myoglobin (MYO) >1000 ng/mL (HR=9.85, 95% CI 5.04-19.28) were independent risk factors for in-hospital death. Additionally, patients with COVID-19 that developed RM tended to have a delayed virus clearance. Conclusion: RM might be an important factor contributing to adverse outcomes of patients with COVID-19. Early detection and effective intervention of RM may help reduce deaths of patients with COVID-19.