key: cord-0935913-4tdg5r4n
authors: Finsterer, Josef; Almas, Talal
title: Broadening the diagnostic approach for SARS‐CoV‐2 associated myopathy and rhabdomyolysis
date: 2021-11-23
journal: Ther Apher Dial
DOI: 10.1111/1744-9987.13758
sha: 7364a3d4b84d5d12d7b56b1332077d7179cc2531
doc_id: 935913
cord_uid: 4tdg5r4n

nan

activated the myotoxic potential of tacrolimus, steroids, atorvastatin, and ezetimibe that the patient was regularly taking already prior to the infection and that remdesivir was not the culprit agent. Tacrolimus, steroids, atorvastatin, and ezetimibe are known for their myotoxic potential [5] .

Missing are the myoglobin levels in the serum and urine for assessing the severity of rhabdomyolysis and the information if quadriparesis was associated with muscle pain or asymptomatic.

As polyradiculitis (Guillain-Barre syndrome [GBS]) can manifest with CK elevation and is a frequent complication of SARS-CoV-2 infections [6] , there is a need to refer patients with acute muscle weakness related to SARS-CoV-2 infectious to the neurologist so as not to overlook GBS.

Overall, the interesting study has several shortcomings which challenge the results and their interpretation. The etiology and pathophysiology of quadriparesis in the index patient remain unsolved as work-up did not include invasive techniques. Acute myopathy in SARS-CoV-2 infected requires extensive, invasive diagnostic approaches not to miss the trigger of the malaise. 

Toxic myopathy and liver damage caused by concomitant therapy with remdesivir, atorvastatin, ezetimibe, and tacrolimus in a renal transplant patient with recently treated SARS-CoV-2 induced pneumonia: a case report

Musculoskeletal symptoms and relationship with laboratory findings in patients with COVID-19

COVID-19 presenting as severe Rhabdomyolysis with Normal renal function

Severe rhabdomyolysis and acute renal failure secondary to concomitant use of simvastatin with rapamycin plus tacrolimus in liver transplant patient

Medically induced myopathia

Guillain-Barre syndrome in 220 patients with COVID-19