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Rhabdomyolysis and severe biphasic disturbance of calcium homeostasis secondary to COVID-19 infection
  1. Adrian Po Zhu Li,
  2. Stephen Thomas,
  3. Refik Gokmen and
  4. Dulmini Kariyawasam
  1. Diabetes and Endocrinology, Guy's and St Thomas' Hospitals NHS Trust, London, UK
  1. Correspondence to Adrian Po Zhu Li; lipozhu{at}


We report a case of severe hypercalcaemia secondary to rhabdomyolysis in a woman with COVID-19 (SARS CoV-2) infection. The patient presented with myalgia and anuria with an acute kidney injury requiring haemodialysis. Creatine kinase peaked at 760 000 IU/L. A biphasic calcaemic response was observed with initial severe hypocalcaemia followed by severe, symptomatic hypercalcaemia, persistent despite haemodialysis. Control of the calcium levels was achieved by continuous haemofiltration.

  • endocrine system
  • renal system
  • calcium and bone
  • adult intensive care
  • acute renal failure

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  • Contributors All authors contributed to the writing and clinical management of the case in the following ways: APZL is the main author of case report, acquired clinical information from case, designed illustrations (figures), obtained consent from patient, in charge of submission process. ST involved in the clinical management of case, conception and planning of case report, reviewing and revising discussion section regarding hypercalcaemia management and causes. RG involved in the clinical management of case, clarification of details regarding haemodialysis versus haemofiltration in the treatment section and discussion section. DK involved in the clinical management of case, conception and planning of case report, reviewing the whole case report, critically revising discussion section and advising on the design of included figures. All authors above have approved the final version of the case report and agreed to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.