tetano
Editor, Senior Moderator
Pediatr Infect Dis J
. 2020 Nov 10.
doi: 10.1097/INF.0000000000002978. Online ahead of print.
Fatal SARS-CoV-2 Inflammatory Syndrome and Myocarditis in an Adolescent: A Case Report
Jeanette T Beaudry[SUP] 1 2 [/SUP], Barbara Dietrick[SUP] 1 [/SUP], Dawn B Lammert[SUP] 1 [/SUP], Alexander Constas[SUP] 3 [/SUP], Julia McCaw[SUP] 3 [/SUP], John Hammond[SUP] 1 [/SUP], Matthew Buendia[SUP] 1 [/SUP], Julie E Stein[SUP] 4 [/SUP], Andrew Pekosz[SUP] 5 [/SUP], Jennifer Schuette[SUP] 3 [/SUP], Heba H Mostafa[SUP] 6 [/SUP], Jody E Hooper[SUP] 4 [/SUP], Meghan Bernier[SUP] 3 [/SUP], Allison Agwu[SUP] 2 7 [/SUP], Leonard S Feldman[SUP] 1 7 [/SUP]
Affiliations
Abstract
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), an entity in children initially characterized by milder case presentations and better prognoses as compared with adults. Recent reports, however, raise concern for a new hyperinflammatory entity in a subset of pediatric COVID-19 patients.
Methods: We report a fatal case of confirmed COVID-19 with hyperinflammatory features concerning for both multi-inflammatory syndrome in children (MIS-C) and primary COVID-19.
Results: This case highlights the ambiguity in distinguishing between these two entities in a subset of pediatric patients with COVID-19-related disease and the rapid decompensation these patients may experience.
Conclusions: Appropriate clinical suspicion is necessary for both acute disease and MIS-C. SARS-CoV-2 serologic tests obtained early in the diagnostic process may help to narrow down the differential but does not distinguish between acute COVID-19 and MIS-C. Better understanding of the hyperinflammatory changes associated with MIS-C and acute COVID-19 in children will help delineate the roles for therapies, particularly if there is a hybrid phenotype occurring in adolescents.
. 2020 Nov 10.
doi: 10.1097/INF.0000000000002978. Online ahead of print.
Fatal SARS-CoV-2 Inflammatory Syndrome and Myocarditis in an Adolescent: A Case Report
Jeanette T Beaudry[SUP] 1 2 [/SUP], Barbara Dietrick[SUP] 1 [/SUP], Dawn B Lammert[SUP] 1 [/SUP], Alexander Constas[SUP] 3 [/SUP], Julia McCaw[SUP] 3 [/SUP], John Hammond[SUP] 1 [/SUP], Matthew Buendia[SUP] 1 [/SUP], Julie E Stein[SUP] 4 [/SUP], Andrew Pekosz[SUP] 5 [/SUP], Jennifer Schuette[SUP] 3 [/SUP], Heba H Mostafa[SUP] 6 [/SUP], Jody E Hooper[SUP] 4 [/SUP], Meghan Bernier[SUP] 3 [/SUP], Allison Agwu[SUP] 2 7 [/SUP], Leonard S Feldman[SUP] 1 7 [/SUP]
Affiliations
- PMID: 33181783
- DOI: 10.1097/INF.0000000000002978
Abstract
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), an entity in children initially characterized by milder case presentations and better prognoses as compared with adults. Recent reports, however, raise concern for a new hyperinflammatory entity in a subset of pediatric COVID-19 patients.
Methods: We report a fatal case of confirmed COVID-19 with hyperinflammatory features concerning for both multi-inflammatory syndrome in children (MIS-C) and primary COVID-19.
Results: This case highlights the ambiguity in distinguishing between these two entities in a subset of pediatric patients with COVID-19-related disease and the rapid decompensation these patients may experience.
Conclusions: Appropriate clinical suspicion is necessary for both acute disease and MIS-C. SARS-CoV-2 serologic tests obtained early in the diagnostic process may help to narrow down the differential but does not distinguish between acute COVID-19 and MIS-C. Better understanding of the hyperinflammatory changes associated with MIS-C and acute COVID-19 in children will help delineate the roles for therapies, particularly if there is a hybrid phenotype occurring in adolescents.