CONCLUSION
Overall, this is likely a case of rhabdomyolysis triggered by an
otherwise asymptomatic COVID-19 infection. Yet, it is important to note
that COVID-19-induced rhabdomyolysis has occurred in the backdrop of
several risk factors, most significantly statin-cyclosporine drug
interaction. This pharmacokinetic interaction leads to elevated plasma
levels of statin, thus risking skeletal muscle damage. COVID-19 may have
just been the trigger that pushed statin-induced myopathy towards
full-blown rhabdomyolysis.
Rhabdomyolysis and AKI may be the only presenting features of COVID-19
infection. Also, it may be worth monitoring CK levels in those patients
who test positive for COVID-19, especially if they have pre-existing
risk factors or symptoms of rhabdomyolysis. Early initiation of
intravenous fluid therapy is the key to management, both to prevent and
treat myoglobin-induced AKI.