tetano
Editor, Senior Moderator
MMWR Morb Mortal Wkly Rep
. 2020 Oct 9;69(40):1450-1456.
doi: 10.15585/mmwr.mm6940e1.
Case Series of Multisystem Inflammatory Syndrome in Adults Associated with SARS-CoV-2 Infection - United Kingdom and United States, March-August 2020
Sapna Bamrah Morris, Noah G Schwartz, Pragna Patel, Lilian Abbo, Laura Beauchamps, Shuba Balan, Ellen H Lee, Rachel Paneth-Pollak, Anita Geevarughese, Maura K Lash, Marie S Dorsinville, Vennus Ballen, Daniel P Eiras, Christopher Newton-Cheh, Emer Smith, Sara Robinson, Patricia Stogsdill, Sarah Lim, Sharon E Fox, Gillian Richardson, Julie Hand, Nora T Oliver, Aaron Kofman, Bobbi Bryant, Zachary Ende, Deblina Datta, Ermias Belay, Shana Godfred-Cato
Abstract
During the course of the coronavirus disease 2019 (COVID-19) pandemic, reports of a new multisystem inflammatory syndrome in children (MIS-C) have been increasing in Europe and the United States (1-3). Clinical features in children have varied but predominantly include shock, cardiac dysfunction, abdominal pain, and elevated inflammatory markers, including C-reactive protein (CRP), ferritin, D-dimer, and interleukin-6 (1). Since June 2020, several case reports have described a similar syndrome in adults; this review describes in detail nine patients reported to CDC, seven from published case reports, and summarizes the findings in 11 patients described in three case series in peer-reviewed journals (4-6). These 27 patients had cardiovascular, gastrointestinal, dermatologic, and neurologic symptoms without severe respiratory illness and concurrently received positive test results for SARS-CoV-2, the virus that causes COVID-19, by polymerase chain reaction (PCR) or antibody assays indicating recent infection. Reports of these patients highlight the recognition of an illness referred to here as multisystem inflammatory syndrome in adults (MIS-A), the heterogeneity of clinical signs and symptoms, and the role for antibody testing in identifying similar cases among adults. Clinicians and health departments should consider MIS-A in adults with compatible signs and symptoms. These patients might not have positive SARS-CoV-2 PCR or antigen test results, and antibody testing might be needed to confirm previous SARS-CoV-2 infection. Because of the temporal association between MIS-A and SARS-CoV-2 infections, interventions that prevent COVID-19 might prevent MIS-A. Further research is needed to understand the pathogenesis and long-term effects of this newly described condition.
. 2020 Oct 9;69(40):1450-1456.
doi: 10.15585/mmwr.mm6940e1.
Case Series of Multisystem Inflammatory Syndrome in Adults Associated with SARS-CoV-2 Infection - United Kingdom and United States, March-August 2020
Sapna Bamrah Morris, Noah G Schwartz, Pragna Patel, Lilian Abbo, Laura Beauchamps, Shuba Balan, Ellen H Lee, Rachel Paneth-Pollak, Anita Geevarughese, Maura K Lash, Marie S Dorsinville, Vennus Ballen, Daniel P Eiras, Christopher Newton-Cheh, Emer Smith, Sara Robinson, Patricia Stogsdill, Sarah Lim, Sharon E Fox, Gillian Richardson, Julie Hand, Nora T Oliver, Aaron Kofman, Bobbi Bryant, Zachary Ende, Deblina Datta, Ermias Belay, Shana Godfred-Cato
- PMID: 33031361
- DOI: 10.15585/mmwr.mm6940e1
Abstract
During the course of the coronavirus disease 2019 (COVID-19) pandemic, reports of a new multisystem inflammatory syndrome in children (MIS-C) have been increasing in Europe and the United States (1-3). Clinical features in children have varied but predominantly include shock, cardiac dysfunction, abdominal pain, and elevated inflammatory markers, including C-reactive protein (CRP), ferritin, D-dimer, and interleukin-6 (1). Since June 2020, several case reports have described a similar syndrome in adults; this review describes in detail nine patients reported to CDC, seven from published case reports, and summarizes the findings in 11 patients described in three case series in peer-reviewed journals (4-6). These 27 patients had cardiovascular, gastrointestinal, dermatologic, and neurologic symptoms without severe respiratory illness and concurrently received positive test results for SARS-CoV-2, the virus that causes COVID-19, by polymerase chain reaction (PCR) or antibody assays indicating recent infection. Reports of these patients highlight the recognition of an illness referred to here as multisystem inflammatory syndrome in adults (MIS-A), the heterogeneity of clinical signs and symptoms, and the role for antibody testing in identifying similar cases among adults. Clinicians and health departments should consider MIS-A in adults with compatible signs and symptoms. These patients might not have positive SARS-CoV-2 PCR or antigen test results, and antibody testing might be needed to confirm previous SARS-CoV-2 infection. Because of the temporal association between MIS-A and SARS-CoV-2 infections, interventions that prevent COVID-19 might prevent MIS-A. Further research is needed to understand the pathogenesis and long-term effects of this newly described condition.