An Atypical Case of COVID-19 Induced Pancytopenia, Rhabdomyolysis and Myocarditis

Abstract

Severe acute respiratory distress coronavirus 2 (SARS-CoV-2) virus is responsible for the current pandemic - coronavirus disease 2019 (COVID-19) plaguing the world. It began spreading as early as January 2020 in the United States (US) and has recently become the leading cause of death amongst adults over 45 years of age. Much of its clinical presentation is already known, and there have been advances in its successful treatment with a food and drug administration (FDA) approved antiviral medication called remdesivir, and other proven investigational methods with clinical benefits including dexamethasone and COVID-19 antibody transfusion called convalescent plasma therapy. However, the recommendations for their use include COVID-19 confirmed patients requiring supplemental oxygen or other forms of respiratory support. In this case report, we describe in detail a unique case of severe COVID-19 infection that did not require any form of oxygen support but was treated successfully with antiviral medications and steroids. The purpose of this report is to highlight in detail an unusual COVID-19 presentation with rhabdomyolysis, myocarditis, and pancytopenia severe enough to require hospitalization and treatment with proven COVID-19 therapy to achieve clinical resolution.

Concurrent myopathy and inflammatory cardiac disease in COVID-19 patients: a case series and literature review

“…We excluded eight cases of patients with only myopathy or inflammatory cardiac disease, five cases with a known myopathy or inflammatory cardiac disease, four cases of patients without COVID-19, three cases describing the effect of COVID-19 vaccine, and one case of a patient under 18 years. The characteristics of the included cases are summarized in Table 2 [18][19][20][21][22]. Median age was 50 (39-78) years and only one patient had a history of prior cardiac disease.…”

Profound Rhabdomyolysis and Viral Myositis Due to SARS-CoV-2: A Case Report

“…Further research in the realm of SARS-CoV-2 myositis and rhabdomyolysis should explore the cellular mechanisms of illness and nuances of risk factors, investigate the impact of different treatment modalities, and elucidate the long-term consequences of rhabdomyolysis in SARS-CoV-2 survivors and nonsurvivors [ 1 , 24 , 25 , 26 ]. Establishing a best early detection and guideline for therapy can lead to early interventions and prevent downstream complications and mortality.…”