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Pediatr Nephrol Pediatric COVID-19-associated Rhabdomyolysis: A Case Report

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  • Pediatr Nephrol Pediatric COVID-19-associated Rhabdomyolysis: A Case Report





    Pediatr Nephrol


    . 2020 May 23.
    doi: 10.1007/s00467-020-04617-0. Online ahead of print.
    Pediatric COVID-19-associated Rhabdomyolysis: A Case Report

    Ashley M Gefen 1 , Nancy Palumbo 2 , Suresh K Nathan 2 , Pamela S Singer 1 , Laura J Castellanos-Reyes 1 , Christine B Sethna 3


    Affiliations

    Abstract

    COVID-19 is the illness caused by infection with the novel coronavirus SARS-CoV-2. Although myalgia is common in adults, it has not been noted as a common symptom in children. There have been a few reported cases of COVID-19-associated rhabdomyolysis in adults. This case report describes a 16-year-old boy who presented with fever, myalgias, mild shortness of breath with exertion, and dark-colored urine. COVID-19 PCR was positive. His initial creatinine kinase (CK) level was 427,656 U/L. Serum creatinine was normal for age. He was treated with isotonic intravenous fluids containing sodium bicarbonate to maintain urine output of 100-200 mL/h and urine pH > 7.0. His serum creatinine remained normal throughout the hospital stay and he was discharged on hospital day 12 with a CK of 6526 U/L. To our knowledge, no pediatric cases of COVID-19-associated rhabdomyolysis have been previously reported. Adult cases of rhabdomyolysis have been reported and a few reports have noted patients with elevated CK levels without rhabdomyolysis. Given this pediatric case of COVID-19-associated rhabdomyolysis, pediatric clinicians should be aware of this complication and manage fluids appropriately in order to prevent acute kidney injury.

    Keywords: Children; Coronavirus; Creatine kinase; SARS-CoV-2.

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