Abstract
We report the case of a 19-year-old male who complained of myalgia, muscle weakness, and darkened urine two days after receiving his Ad26.COV2.S (Johnson & Johnson, New Brunswick, New Jersey, United States) COVID-19 vaccination. Blood examination revealed an increased creatine kinase (CK) level, and his urinary dipstick tested positive for blood, indicative of acute rhabdomyolysis. Serum creatinine levels were normal. Rhabdomyolysis due to strenuous physical activity was ruled out and further diagnostics excluded an autoimmune cause. Under repeated treatment with intravenous fluid resuscitation (outpatient treatment), his symptoms resolved and peak CK levels of 44,180 U/L returned to almost normal levels within two weeks. Rhabdomyolysis is a rare, potentially fatal vaccine-induced reaction. Further research is needed to better understand the underlying pathomechanism and to investigate whether subcutaneous injection of vaccines may be able to prevent rhabdomyolysis.
Highlights
Vaccines 2021, 9, 956. https://The recent outbreak of the coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has presented a major challenge for health care systems worldwide
We report the case of a 19-year-old previously healthy man, who developed severe rhabdomyolysis two days after receiving the Ad26.COV2.S
Rhabdomyolysis is defined as destruction of striped muscle cells with subsequent release of its contents, most notably electrolytes, myoglobin, creatine kinase, lactate dehydrogenase, alanine aminotransferase, and aspartate aminotransferase into the circulation [5]
Summary
The recent outbreak of the coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has presented a major challenge for health care systems worldwide. With the long-awaited emergence of vaccines against SARS-CoV-2, vaccination side-effects are once again in the spotlight. While common reactions include injection site pain, fever, malaise, and headache, other more dangerous side-effects, such as vaccine-induced immune thrombotic thrombocytopenia, were reported [1]. A single dose of Ad26.COV2.S protected against symptomatic COVID-19 infection and was effective against severe-critical disease [4]. We report the case of a 19-year-old previously healthy man, who developed severe rhabdomyolysis two days after receiving the Ad26.COV2.S. Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations
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