MIS-C After ARDS Associated With SARS-CoV-2

Clouser, Katharine N.; Baer, Aryeh; Bhavsar, Sejal Makvana; Gadhavi, Jasmine; Li, Suzanne; Schnall, Jeremy; Weiss, Jennifer E.

doi:10.1097/inf.0000000000002879

Cited by 4 publications

(7 citation statements)

References 8 publications

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“…Cases of patients in this study have been published previously at least in part (Appendix; available at www.jpeds.com ). 2 , 3 , 11 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 …”

Section: Methodsmentioning

confidence: 99%

Severe Acute Respiratory Syndrome Coronavirus 2 Clinical Syndromes and Predictors of Disease Severity in Hospitalized Children and Youth

Fernandes

Oliveira

Guerguis

et al. 2021

The Journal of Pediatrics

173

230

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Objective To characterize the demographic and clinical features of pediatric SARS-CoV-2 syndromes and identify admission variables predictive of disease severity. Study design We conducted a multicenter, retrospective and prospective study of pediatric patients hospitalized with acute SARS-CoV-2 infections and multisystem inflammatory syndrome in children (MIS-C) at eight sites in New York, New Jersey, and Connecticut. Results We identified 281 hospitalized patients with SARS-CoV-2 infections and divided them into three groups based on clinical features. Overall, 143 (51%) had respiratory disease, 69 (25%) had MIS-C, and 69 (25%) had other manifestations including gastrointestinal illness or fever. Patients with MIS-C were more likely to identify as non-Hispanic black compared with patients with respiratory disease (35% versus 18%, P =.02). Seven patients (2%) died and 114 (41%) were admitted to the ICU. In multivariable analyses, obesity (OR=3.39, 95% CI:1.26-9.10, P =.02) and hypoxia on admission (OR=4.01; 95% CI:1.14-14.15; P =.03) were predictive of severe respiratory disease. Lower absolute lymphocyte count (OR=8.33 per unit decrease in 10 9 cells/L, 95% CI:2.32-33.33, P =.001) and higher C-reactive protein (OR=1.06 per unit increase in mg/dL, 95% CI:1.01-1.12, P =.017) were predictive of severe MIS-C. Race/ethnicity or socioeconomic status were not predictive of disease severity. Conclusions We identified variables at the time of hospitalization that may help predict the development of severe SARS-CoV-2 disease manifestations in children and youth. These variables may have implications for future prognostic tools that inform hospital admission and clinical management.

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“…Cases of patients in this study have been published previously at least in part (Appendix; available at www.jpeds.com ). 2 , 3 , 11 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 …”

Section: Methodsmentioning

confidence: 99%

Severe Acute Respiratory Syndrome Coronavirus 2 Clinical Syndromes and Predictors of Disease Severity in Hospitalized Children and Youth

Fernandes

Oliveira

Guerguis

et al. 2021

The Journal of Pediatrics

173

230

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“…A patient with newly diagnosed Crohn's was found to have MIS-C [70], presenting with fever, abdominal pain, with physical exam showing tachycardia, a facial maculopapular rash, and perianal abscess with drainage. Respiratory symptoms were rare, usually presenting with cough or dyspnea [8,9,42,43,46,47,49,51,54,57,60,62,69], or rhinorrhea [42]. Cardiac dysfunction [6, 29,43,71] was seen, with chest pain [9, 50] on presentation, myocarditis [8,43], and coronary artery dilatation/ aneurysm [43].…”

Section: Signs Symptoms and Physical Examinationmentioning

confidence: 99%

“…Mortality was seen in 14 patients with COVID-19 related neurological involvement [72]. Many of the cases studied took a turn for the worse, with signs and symptoms of prolonged inflammation [40], tachycardia [9, 30,44,46,47,50,57,63], bradycardia [67] with conduction abnormalities [67,73], hypotension [9, 43,44,64,67], somnolence [50,51], hypotonia [51], hypoxia [48,67], respiratory failure [54] and shock [6, 30,40,43,48,54,56], with admission to the intensive unit care [48,50]. In many, the symptoms were very similar to those of KD [6, 29,30,41,[44][45][46]48 [42,43,47,72], TSS [41,49,67,68], cytokine storm, HLH, [41] septic shock…”

Section: Signs Symptoms and Physical Examinationmentioning

confidence: 99%

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MIS-C related to SARS-CoV-2 infection: a narrative review of presentation, differential diagnosis, and management

et al. 2022

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Multisystem Inflammatory Syndrome in Children (MIS-C), a rare condition, has been reported approximately 2-4 weeks after the onset of COVID-19 in children and adolescents, causing inflammation in multiple systems, including cardiovascular and respiratory, digestive, and central nervous systems. This condition is also known as hyperinflammatory shock, Kawasaki-like disease, and Pediatric Inflammatory Multisystem Syndrome (PIMS). The signs and symptoms include but are not limited to fever, rash, peripheral edema, gastrointestinal symptoms, conjunctivitis, and shock. Thirty-eight studies met our criteria, with a total of 5822 patients. The most affected population was between 5-18 years of age. We noted that MIS-C presented with a wide range of signs and symptoms that overlap with Kawasaki Disease, including high fever, sore throat, malaise, tachypnea, tachycardia, conjunctival injection, mucosal edema, cardiac involvement, and gastrointestinal symptoms. It causes an increase SUMMARY in IL-17A, IL-6, and arterial damage, a distinct difference from Kawasaki disease. The laboratory findings in MIS-C showed an increase in inflammatory markers like CRP, ESR, ferritin, leukocytes, and TNF-α. WHO stated that 23% of affected children with MIS-C had underlying conditions like chronic lung diseases, cardiovascular disease, and immunosuppression. In most affected children, aspirin and IVIG were successful, which resulted in a decrease in the inflammatory markers. We find that MIS-C is a rare, but potentially fatal pediatric complication, after COVID-19 infection. The aim of this article is to study the emerging relationship between COVID-19 and MIS-C in children and adolescents affected by this condition, to discuss the immunological mechanisms, and explore potential therapies.

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“…In the early months of the pandemic, while the number of cases and deaths in adults continued to rise, the disease did not appear to affect infants and children as much as adults (6). Later on, the multisystem inflammatory syndrome was described in children, which could affect all organs, including the brain (7). Meningitis has been implicated in previous reports, although in those cases, it was not in infancy (8,9).…”

Section: Discussionmentioning

confidence: 99%

A Case Report of Late-Onset Neonatal Meningitis Caused by SARS-CoV-2

Jamali

Dehghani

Hosseininasab

2021

Arch Pediatr Infect Dis

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Introduction: Central nervous system involvement by SARS-CoV-19 appears to be very rare in neonates. We report a case of viral meningitis in a neonate admitted to Kerman Afzalipour Hospital in Southeastern Iran. Case Presentation: The patient was a 15-day-old neonate who presented with lethargy, fever, and poor feeding the day before admission. After the initial evaluation and experimental treatment, viral meningitis was diagnosed with SARS- CoV-19 by polymerase chain reaction (PCR) analysis of cerebrospinal fluid. Empirical treatment was done with antibiotics and supportive care. After viral meningitis was confirmed, the antibiotics were discontinued. In a follow-up two weeks later, the neonate had a good condition with no particular problem. Conclusions: This report is a case of SARS-CoV-2 meningitis in a neonate. Therefore, if there is epidemiological evidence, the central nervous system involvement due to this virus should also be considered in neonates.

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MIS-C After ARDS Associated With SARS-CoV-2

Cited by 4 publications

References 8 publications

Severe Acute Respiratory Syndrome Coronavirus 2 Clinical Syndromes and Predictors of Disease Severity in Hospitalized Children and Youth

Severe Acute Respiratory Syndrome Coronavirus 2 Clinical Syndromes and Predictors of Disease Severity in Hospitalized Children and Youth

MIS-C related to SARS-CoV-2 infection: a narrative review of presentation, differential diagnosis, and management

A Case Report of Late-Onset Neonatal Meningitis Caused by SARS-CoV-2

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