Neonatal Multisystem Inflammatory Syndrome (MIS-N) Associated with Prenatal Maternal SARS-CoV-2: A Case Series
Multisystem inflammatory syndrome in children (MIS-C) is a post-infectious immune-mediated condition, seen 3–5 weeks after COVID-19. Maternal SARS-CoV-2 may potentially cause a similar hyperinflammatory syndrome in neonates due to transplacental transfer of antibodies. We reviewed the perinatal hist...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-07-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/8/7/572 |
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| author | Ravindra Pawar Vijay Gavade Nivedita Patil Vijay Mali Amol Girwalkar Vyankatesh Tarkasband Sanjog Loya Amit Chavan Narendra Nanivadekar Rahul Shinde Uday Patil Satyan Lakshminrusimha |
| author_facet | Ravindra Pawar Vijay Gavade Nivedita Patil Vijay Mali Amol Girwalkar Vyankatesh Tarkasband Sanjog Loya Amit Chavan Narendra Nanivadekar Rahul Shinde Uday Patil Satyan Lakshminrusimha |
| author_sort | Ravindra Pawar |
| collection | DOAJ |
| description | Multisystem inflammatory syndrome in children (MIS-C) is a post-infectious immune-mediated condition, seen 3–5 weeks after COVID-19. Maternal SARS-CoV-2 may potentially cause a similar hyperinflammatory syndrome in neonates due to transplacental transfer of antibodies. We reviewed the perinatal history, clinical features, and outcomes of 20 neonates with features consistent with MIS-C related to maternal SARS-CoV-2 in Kolhapur, India, from 1 September 2020 to 30 April 2021. Anti-SARS-CoV-2 IgG and IgM antibodies were tested in all neonates. Fifteen singletons and five twins born to eighteen mothers with a history of COVID-19 disease or exposure during pregnancy presented with features consistent with MIS-C during the first 5 days after birth. Nineteen were positive for anti-SARS-CoV-2 IgG and all were negative for IgM antibodies. All mothers were asymptomatic and therefore not tested by RTPCR-SARS-CoV-2 at delivery. Eighteen neonates (90%) had cardiac involvement with prolonged QTc, 2:1 AV block, cardiogenic shock, or coronary dilatation. Other findings included respiratory failure (40%), fever (10%), feeding intolerance (30%), melena (10%), and renal failure (5%). All infants had elevated inflammatory biomarkers and received steroids and IVIG. Two infants died. We speculate that maternal SARS-CoV-2 and transplacental antibodies cause multisystem inflammatory syndrome in neonates (MIS-N). Immunomodulation may be beneficial in some cases, but further studies are needed. |
| first_indexed | 2024-03-10T09:42:20Z |
| format | Article |
| id | doaj.art-aa98f145189040d495fae0d1880e2461 |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-10T09:42:20Z |
| publishDate | 2021-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-aa98f145189040d495fae0d1880e24612023-11-22T03:31:34ZengMDPI AGChildren2227-90672021-07-018757210.3390/children8070572Neonatal Multisystem Inflammatory Syndrome (MIS-N) Associated with Prenatal Maternal SARS-CoV-2: A Case SeriesRavindra Pawar0Vijay Gavade1Nivedita Patil2Vijay Mali3Amol Girwalkar4Vyankatesh Tarkasband5Sanjog Loya6Amit Chavan7Narendra Nanivadekar8Rahul Shinde9Uday Patil10Satyan Lakshminrusimha11Department of Pediatrics, Dr. D Y Patil Medical College Hospital and Research Institute, Kolhapur 416003, MH, IndiaMasai Children’s Hospital, Kolhapur 416002, MH, IndiaDepartment of Pediatrics, Dr. D Y Patil Medical College Hospital and Research Institute, Kolhapur 416003, MH, IndiaDepartment of Pediatrics, Dr. D Y Patil Medical College Hospital and Research Institute, Kolhapur 416003, MH, IndiaRatna NICU, Kolhapur 416003, MH, IndiaDepartment of Pediatrics, Apple Saraswati Multispeciality Hospital, Kolhapur 416003, MH, IndiaMasai Children’s Hospital, Kolhapur 416002, MH, IndiaMasai Children’s Hospital, Kolhapur 416002, MH, IndiaNiramay Pediatric Nursing Home and Eye Care Centre, Kolhapur 416001, MH, IndiaSamarth Nursing Home, Kolhapur 416002, MH, IndiaMasai Children’s Hospital, Kolhapur 416002, MH, IndiaUC Davis Children’s Hospital, Sacramento, CA 95817, USAMultisystem inflammatory syndrome in children (MIS-C) is a post-infectious immune-mediated condition, seen 3–5 weeks after COVID-19. Maternal SARS-CoV-2 may potentially cause a similar hyperinflammatory syndrome in neonates due to transplacental transfer of antibodies. We reviewed the perinatal history, clinical features, and outcomes of 20 neonates with features consistent with MIS-C related to maternal SARS-CoV-2 in Kolhapur, India, from 1 September 2020 to 30 April 2021. Anti-SARS-CoV-2 IgG and IgM antibodies were tested in all neonates. Fifteen singletons and five twins born to eighteen mothers with a history of COVID-19 disease or exposure during pregnancy presented with features consistent with MIS-C during the first 5 days after birth. Nineteen were positive for anti-SARS-CoV-2 IgG and all were negative for IgM antibodies. All mothers were asymptomatic and therefore not tested by RTPCR-SARS-CoV-2 at delivery. Eighteen neonates (90%) had cardiac involvement with prolonged QTc, 2:1 AV block, cardiogenic shock, or coronary dilatation. Other findings included respiratory failure (40%), fever (10%), feeding intolerance (30%), melena (10%), and renal failure (5%). All infants had elevated inflammatory biomarkers and received steroids and IVIG. Two infants died. We speculate that maternal SARS-CoV-2 and transplacental antibodies cause multisystem inflammatory syndrome in neonates (MIS-N). Immunomodulation may be beneficial in some cases, but further studies are needed.https://www.mdpi.com/2227-9067/8/7/572neonatemultisystem inflammatory syndrome in children (MIS-C)anti SARS-CoV-2 antibodiesCOVID-19 |
| spellingShingle | Ravindra Pawar Vijay Gavade Nivedita Patil Vijay Mali Amol Girwalkar Vyankatesh Tarkasband Sanjog Loya Amit Chavan Narendra Nanivadekar Rahul Shinde Uday Patil Satyan Lakshminrusimha Neonatal Multisystem Inflammatory Syndrome (MIS-N) Associated with Prenatal Maternal SARS-CoV-2: A Case Series Children neonate multisystem inflammatory syndrome in children (MIS-C) anti SARS-CoV-2 antibodies COVID-19 |
| title | Neonatal Multisystem Inflammatory Syndrome (MIS-N) Associated with Prenatal Maternal SARS-CoV-2: A Case Series |
| title_full | Neonatal Multisystem Inflammatory Syndrome (MIS-N) Associated with Prenatal Maternal SARS-CoV-2: A Case Series |
| title_fullStr | Neonatal Multisystem Inflammatory Syndrome (MIS-N) Associated with Prenatal Maternal SARS-CoV-2: A Case Series |
| title_full_unstemmed | Neonatal Multisystem Inflammatory Syndrome (MIS-N) Associated with Prenatal Maternal SARS-CoV-2: A Case Series |
| title_short | Neonatal Multisystem Inflammatory Syndrome (MIS-N) Associated with Prenatal Maternal SARS-CoV-2: A Case Series |
| title_sort | neonatal multisystem inflammatory syndrome mis n associated with prenatal maternal sars cov 2 a case series |
| topic | neonate multisystem inflammatory syndrome in children (MIS-C) anti SARS-CoV-2 antibodies COVID-19 |
| url | https://www.mdpi.com/2227-9067/8/7/572 |
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