Coronavirus disease 2019 (COVID-19) typically manifests with respiratory symptoms
and can ultimately progress to severe multiorgan failure. Viral myositis,
systemic capillary leak syndrome, and arteriovenous thrombosis are atypical
manifestations of COVID-19. We present a case of a 33-year-old woman, fully
vaccinated against COVID-19, who developed myositis and shock. She ultimately
required bilateral lower extremity fasciotomies secondary to compartment
syndrome, presumably from COVID-19 myositis. Although compartment syndrome from
COVID-19 myositis has been reported for ocular, hand, and thigh compartment
syndromes, this is the first case report showing bilateral lower extremity
compartment syndrome secondary to COVID-19 myositis in a fully vaccinated
individual. As we learn more about COVID-19 and its extrapulmonary effects, it
is imperative to consider all working diagnoses when working up patients.
Providers must be aware of extrapulmonary effects of COVID-19, particularly in
individuals who might deviate from traditional symptoms.