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Muscle involvement in SARS-CoV-2 infection.

Abstract：

BACKGROUND AND PURPOSE:Since the outbreak of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, several reports indicated neurological involvement in COVID-19 disease. Muscle involvement has also been reported as evidenced by creatine kinase (CK) elevations and reports of myalgia. METHODS:Creatine kinase, markers of inflammation, pre-existing diseases and statin use were extracted from records of Austrian hospitalised COVID-19 patients. Disease severity was classified as severe in case of intensive care unit (ICU) admission or mortality. COVID-19 patients were additionally compared to an historical group of hospitalised influenza patients. RESULTS:Three hundred fifty-one patients with SARS-CoV-2 and 258 with influenza were included in the final analysis. CK was elevated in 27% of COVID-19 and in 28% of influenza patients. CK was higher in severe COVID-19 as were markers of inflammation. CK correlated significantly with inflammation markers, which had an independent impact on CK when adjusted for demographic variables and disease severity. Compared to influenza patients, COVID-19 patients were older, more frequently male, had more comorbidities, and more frequently had a severe disease course. Nevertheless, influenza patients had higher baseline CK than COVID-19, and 35.7% of intensive care unit (ICU)-admitted patients had CK levels >1000 U/l compared to only 4.7% of ICU-admitted COVID-19 patients. CONCLUSIONS:HyperCKemia occurs in a similar frequency in COVID-19 and influenza infection. CK levels were lower in COVID-19 than in influenza in mild and severe disease. CK levels strongly correlate with disease severity and markers of inflammation. To date, it remains unclear whether hyperCKemia is due to a virus-triggered inflammatory response or direct muscle toxicity.

journal_name

Eur J Neurol

journal_title

European journal of neurology

authors

Pitscheider L,Karolyi M,Burkert FR,Helbok R,Wanschitz JV,Horlings C,Pawelka E,Omid S,Traugott M,Seitz T,Zoufaly A,Lindeck-Pozza E,Wöll E,Beer R,Seiwald S,Bellmann-Weiler R,Hegen H,Löscher WN

doi

10.1111/ene.14564

subject

Has Abstract

pub_date

2020-09-30 00:00:00

eissn

1351-5101

issn

1468-1331

pub_type

杂志文章

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