Multisystem Inflammatory Syndrome in Adults Associated with Recent Infection with COVID-19
Multisystem inflammatory syndrome in adults (MIS-A) is an uncommon but severe and still understudied post-infectious complication of COVID-19. Clinically, the disease manifests itself most often 2–6 weeks after overcoming the infection. Young and middle-aged patients are especially affected. The cli...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-03-01
|
| Series: | Diagnostics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4418/13/5/983 |
| _version_ | 1797615517042737152 |
|---|---|
| author | Ondrej Zahornacky Štefan Porubčin Alena Rovnakova Pavol Jarcuska |
| author_facet | Ondrej Zahornacky Štefan Porubčin Alena Rovnakova Pavol Jarcuska |
| author_sort | Ondrej Zahornacky |
| collection | DOAJ |
| description | Multisystem inflammatory syndrome in adults (MIS-A) is an uncommon but severe and still understudied post-infectious complication of COVID-19. Clinically, the disease manifests itself most often 2–6 weeks after overcoming the infection. Young and middle-aged patients are especially affected. The clinical picture of the disease is very diverse. The dominant symptoms are mainly fever and myalgia, usually accompanied by various, especially extrapulmonary, manifestations. Cardiac damage (often in the form of cardiogenic shock) and significantly increased inflammatory parameters are often associated with MIS-A, while respiratory symptoms, including hypoxia, are less frequent. Due to the seriousness of the disease and the possibility of rapid progression, the basis of a successful treatment of the patient is early diagnosis, based mainly on anamnesis (overcoming the disease of COVID-19 in the recent past) and clinical symptoms, which often imitate other severe conditions such as, e.g., sepsis, septic shock, or toxic shock syndrome. Because of the danger of missing the treatment, it is necessary to initiate it immediately after the suspicion of MIS-A is expressed, without waiting for the results of microbiological and serological examinations. The cornerstone of pharmacological therapy is the administration of corticosteroids and intravenous immunoglobulins, to which the majority of patients clinically react. In this article, the authors describe the case report of a 21-year-old patient admitted to the Clinic of Infectology and Travel Medicine for febrility up to 40.5 °C, myalgia, arthralgia, headache, vomiting, and diarrhea three weeks after overcoming COVID-19. However, as part of the routine differential diagnosis of fevers (imaging and laboratory examinations), their cause was not clarified. Due to the overall worsening of the condition, the patient was transferred to the ICU with suspicion of developing MIS-A (he met all clinical and laboratory criteria). Given the above, reserve antibiotics, intravenous corticosteroids, and immunoglobulins were added to the treatment due to the risk of missing them, with a good clinical and laboratory effect. After stabilizing the condition and adjusting the laboratory parameters, the patient was transferred to a standard bed and sent home. |
| first_indexed | 2024-03-11T07:27:38Z |
| format | Article |
| id | doaj.art-6ac5622b812f4f0abed65aba67b05946 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T07:27:38Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-6ac5622b812f4f0abed65aba67b059462023-11-17T07:30:51ZengMDPI AGDiagnostics2075-44182023-03-0113598310.3390/diagnostics13050983Multisystem Inflammatory Syndrome in Adults Associated with Recent Infection with COVID-19Ondrej Zahornacky0Štefan Porubčin1Alena Rovnakova2Pavol Jarcuska3Department of Infectology and Travel Medicine, Faculty of Medicine, Louis Pasteur University Hospital, Pavol Jozef Šafarik University, 04190 Košice, SlovakiaDepartment of Infectology and Travel Medicine, Faculty of Medicine, Louis Pasteur University Hospital, Pavol Jozef Šafarik University, 04190 Košice, SlovakiaDepartment of Infectology and Travel Medicine, Faculty of Medicine, Louis Pasteur University Hospital, Pavol Jozef Šafarik University, 04190 Košice, SlovakiaDepartment of Infectology and Travel Medicine, Faculty of Medicine, Louis Pasteur University Hospital, Pavol Jozef Šafarik University, 04190 Košice, SlovakiaMultisystem inflammatory syndrome in adults (MIS-A) is an uncommon but severe and still understudied post-infectious complication of COVID-19. Clinically, the disease manifests itself most often 2–6 weeks after overcoming the infection. Young and middle-aged patients are especially affected. The clinical picture of the disease is very diverse. The dominant symptoms are mainly fever and myalgia, usually accompanied by various, especially extrapulmonary, manifestations. Cardiac damage (often in the form of cardiogenic shock) and significantly increased inflammatory parameters are often associated with MIS-A, while respiratory symptoms, including hypoxia, are less frequent. Due to the seriousness of the disease and the possibility of rapid progression, the basis of a successful treatment of the patient is early diagnosis, based mainly on anamnesis (overcoming the disease of COVID-19 in the recent past) and clinical symptoms, which often imitate other severe conditions such as, e.g., sepsis, septic shock, or toxic shock syndrome. Because of the danger of missing the treatment, it is necessary to initiate it immediately after the suspicion of MIS-A is expressed, without waiting for the results of microbiological and serological examinations. The cornerstone of pharmacological therapy is the administration of corticosteroids and intravenous immunoglobulins, to which the majority of patients clinically react. In this article, the authors describe the case report of a 21-year-old patient admitted to the Clinic of Infectology and Travel Medicine for febrility up to 40.5 °C, myalgia, arthralgia, headache, vomiting, and diarrhea three weeks after overcoming COVID-19. However, as part of the routine differential diagnosis of fevers (imaging and laboratory examinations), their cause was not clarified. Due to the overall worsening of the condition, the patient was transferred to the ICU with suspicion of developing MIS-A (he met all clinical and laboratory criteria). Given the above, reserve antibiotics, intravenous corticosteroids, and immunoglobulins were added to the treatment due to the risk of missing them, with a good clinical and laboratory effect. After stabilizing the condition and adjusting the laboratory parameters, the patient was transferred to a standard bed and sent home.https://www.mdpi.com/2075-4418/13/5/983COVID-19infectionmultisysteminflammatoryMIS-A |
| spellingShingle | Ondrej Zahornacky Štefan Porubčin Alena Rovnakova Pavol Jarcuska Multisystem Inflammatory Syndrome in Adults Associated with Recent Infection with COVID-19 Diagnostics COVID-19 infection multisystem inflammatory MIS-A |
| title | Multisystem Inflammatory Syndrome in Adults Associated with Recent Infection with COVID-19 |
| title_full | Multisystem Inflammatory Syndrome in Adults Associated with Recent Infection with COVID-19 |
| title_fullStr | Multisystem Inflammatory Syndrome in Adults Associated with Recent Infection with COVID-19 |
| title_full_unstemmed | Multisystem Inflammatory Syndrome in Adults Associated with Recent Infection with COVID-19 |
| title_short | Multisystem Inflammatory Syndrome in Adults Associated with Recent Infection with COVID-19 |
| title_sort | multisystem inflammatory syndrome in adults associated with recent infection with covid 19 |
| topic | COVID-19 infection multisystem inflammatory MIS-A |
| url | https://www.mdpi.com/2075-4418/13/5/983 |
| work_keys_str_mv | AT ondrejzahornacky multisysteminflammatorysyndromeinadultsassociatedwithrecentinfectionwithcovid19 AT stefanporubcin multisysteminflammatorysyndromeinadultsassociatedwithrecentinfectionwithcovid19 AT alenarovnakova multisysteminflammatorysyndromeinadultsassociatedwithrecentinfectionwithcovid19 AT pavoljarcuska multisysteminflammatorysyndromeinadultsassociatedwithrecentinfectionwithcovid19 |