Concurrent Fulminant Myocarditis and Severe Rhabdomyolysis in COVID-19-related Multisystem Inflammatory Syndrome in Adults: A Case Report and Review of the Literature.

This case report describes a 47-year-old woman with coronavirus disease 2019 (COVID-19)-related multisystem inflammatory syndrome in adults (MIS-A), who presented with fulminant myocarditis and severe rhabdomyolysis. Despite the absence of severe respiratory symptoms, the patient showed remarkable myocardial and leg edema with significant systemic inflammation and elevated creatine kinase levels after the COVID-19 infection. The patient required venoarterial extracorporeal membrane oxygenation (VA-ECMO) and Impella CP® for hemodynamic stabilization; however, she was successfully treated. We also reviewed reported cases of concurrent myocarditis and muscular involvement in patients with COVID-19, as well as cases of fulminant myocarditis and MIS-A requiring VA-ECMO.