Recovery does not always signal the end of the battle: A case of post SARS-CoV-2 multisystem inflammatory syndrome in an adult

Balan, Shuba; Beauchamps, Laura; Zamora, Jose Armando Gonzales; Vu, Christine; Amoros, Annette; Quiroz, Tanya; Stevenson, Mario; Sharkey, Mark E.; Andrews, David; Abbo, Lilian

doi:10.1016/j.idcr.2021.e01067

Cited by 4 publications

(7 citation statements)

References 23 publications

(35 reference statements)

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“…A total of 221 patients with MIS-A were identified: 102 were from the CDC’s MIS-C surveillance system, of whom 55 were described in a recent publication 3 ; 20 were from voluntary reports to the CDC, of whom 9 were included in a recent publication 2 ; and 99 were from case reports published in the literature. 2 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , …”

Section: Resultsmentioning

confidence: 99%

“…A total of 221 patients with MIS-A were identified: 102 were from the CDC’s MIS-C surveillance system, of whom 55 were described in a recent publication; 20 were from voluntary reports to the CDC, of whom 9 were included in a recent publication; and 99 were from case reports published in the literature . Two clinician reviewers (P.P.…”

Section: Resultsmentioning

confidence: 99%

“…In total, 449 relevant articles were identified, and 86 were selected for in-depth review; of these, 60 had data for patients with MIS-A. 2 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 Figure 1 summarizes...…”

Section: Methodsmentioning

confidence: 99%

“…Authors were contacted for clarification if needed. In total, 449 relevant articles were identified, and 86 were selected for in-depth review; of these, 60 had data for patients with MIS-A Figure 1. summarizes the study selection process.…”

Section: Methodsmentioning

confidence: 99%

“…However, efforts are needed to distinguish it from biphasic acute COVID-19. Using both RT-PCR and serologic testing for antibodies may aid in the diagnosis of MIS-A, especially among persons who had asymptomatic acute COVID-19, because IgG antibodies become detectable 3 to 4 weeks after SARS-CoV-2 infection, 75 at the time when MIS-A commonly presents (median, 28 [IQR, [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] days). In addition, owing to comorbidities, some individuals may be delayed in mounting an antibody response and have persistently positive SARS-CoV-2 RNA.…”

Section: Clinicians Should Consider a Diagnosis Of Mis-mentioning

confidence: 99%

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Clinical Characteristics of Multisystem Inflammatory Syndrome in Adults

et al. 2021

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Key Points Question What are the clinical characteristics of multisystem inflammatory syndrome in adults (MIS-A)? Findings This systematic review of patients with MIS-A reported in the literature and to the US Centers for Disease Control and Prevention identified 221 patients worldwide. The syndrome presented approximately 4 weeks after acute COVID-19 with hyperinflammation and extrapulmonary multiorgan involvement that may be difficult to discern from acute biphasic COVID-19 and postacute sequelae of SARS-CoV-2 infection. Meaning These findings suggest that MIS-A occurs in the postacute COVID-19 period with a heterogeneous clinical presentation likely owing to a dysregulated immune response.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Clinicians Should Consider a Diagnosis Of Mis-mentioning

confidence: 99%

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Clinical Characteristics of Multisystem Inflammatory Syndrome in Adults

et al. 2021

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Multisystem inflammatory syndrome in systemic lupus erythematosus patient with COVID‐19: Case report and review

Luo

2023

Int J of Rheum Dis

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Multisystem inflammatory syndrome in adults (MIS‐A) is considered a rare and serious complication of coronavirus disease 2019, which more frequently occurs in young, male, and either non‐Hispanic black or Hispanic persons. Here we present a Chinese woman aged 50 years with systemic lupus erythematosus diagnosed with MIS‐A. She experienced unexpected sudden cardiac and liver injuries and hemodynamic collapse, and her platelet count dropped sharply on hospital day 2. Unfortunately, the patient's condition gradually deteriorated despite maximum support and she died on day 3. We present this rare case to emphasize that MIS‐A in autoimmune diseases may be more severe and its management may be more difficult.

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Multisystem inflammatory syndrome in adults: a case report and review of the literature

2022

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Background The current coronavirus disease pandemic has brought recognition of multisystem inflammatory syndrome in adults as a de novo entity, temporally associated with severe acute respiratory syndrome coronavirus 2 viral infection in adults. Hypothesis about its true pathophysiology remains controversial. Case report The patient was a 22-year-old African American female presenting to the emergency department with fever, sore throat, and neck swelling for the past 3 days. During her initial emergency department visit, her blood pressure was stable at 110/57 mmHg, temperature of 39.4 °C, and heart rate of 150 beats per minute. While in the emergency department, she received broad-spectrum antibiotics (vancomycin and ceftriaxone) and 30 cc/kg bolus of normal saline. Originally, she was admitted to a telemetry floor. The following night, a rapid response code was called due to hypotension. At that time, her blood pressure was 80/57 mmHg. She appeared comfortable without signs of respiratory distress. She received intravenous fluids and vasopressors, and was transferred to the intensive care unit. The patient had reported a previous coronavirus disease infection a few weeks prior. She was diagnosed and treated for multisystem inflammatory syndrome in adults. Intravenous immunoglobulin infusion was initiated and completed on hospital day 5. She was weaned off vasopressors by day 6, and discharged home on day 11. Conclusion Our case report is an example of the presentation, diagnosis, and management of multisystem inflammatory syndrome. Our research into previous case reports illustrates the wide range of presentations, degree of end organ damage, and treatment modalities. This diagnosis needs to be considered in the presence of recent coronavirus disease infection with new-onset end organ failure, as prompt diagnosis and treatment is crucial for better outcomes.

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Recovery does not always signal the end of the battle: A case of post SARS-CoV-2 multisystem inflammatory syndrome in an adult

Cited by 4 publications

References 23 publications

Clinical Characteristics of Multisystem Inflammatory Syndrome in Adults

Clinical Characteristics of Multisystem Inflammatory Syndrome in Adults

Multisystem inflammatory syndrome in systemic lupus erythematosus patient with COVID‐19: Case report and review

Multisystem inflammatory syndrome in adults: a case report and review of the literature

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