Beware of the ambiguous enemy of multisystem inflammatory syndrome in adult (MIS‐A) following Covid‐19 infection or vaccination

Abstract Multisystem Inflammatory Syndrome is a rare and novel clinical presentation described during the evolving COVID‐19 pandemic. The condition is usually presenting as a sepsis‐like syndrome leading to secondary multi‐organ dysfunction post–COVID‐19 infection. Although the syndrome has been mai...

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Autores principales:	Ahmad Al Bishawi, Maisa Ali, Khaled Al‐Zubaidi, Hamad Abdelhadi
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	COVID‐19 cytokine storm MIS‐A SARS‐CoV‐2 sepsis Medicine R Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/72c325cd26af400f84bd62e19a5f6a7e
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spelling	oai:doaj.org-article:72c325cd26af400f84bd62e19a5f6a7e2021-12-01T06:36:10ZBeware of the ambiguous enemy of multisystem inflammatory syndrome in adult (MIS‐A) following Covid‐19 infection or vaccination2050-090410.1002/ccr3.5138https://doaj.org/article/72c325cd26af400f84bd62e19a5f6a7e2021-11-01T00:00:00Zhttps://doi.org/10.1002/ccr3.5138https://doaj.org/toc/2050-0904Abstract Multisystem Inflammatory Syndrome is a rare and novel clinical presentation described during the evolving COVID‐19 pandemic. The condition is usually presenting as a sepsis‐like syndrome leading to secondary multi‐organ dysfunction post–COVID‐19 infection. Although the syndrome has been mainly described in children, rare adults' form has been similarly described. We are describing a 37‐year‐old female patient presented with fever and neck pain after 1 month of a mild SARS‐CoV‐2 infection course and 10 days post her second COVID‐19 vaccine. Examination demonstrated fever, hypotension, and hypoxemia, in addition to multiple tender cervical lymph nodes. Initial laboratory workup showed evidence of significant inflammation with raised markers, including C‐reactive protein, ferritin, and interleukin‐6. Extensive evaluation to rule out active infection was done, and all return negative, including repeat SARS‐CoV‐2 test. Furthermore, cardiac evaluation showed moderately reduced systolic ventricular function. Despite all negative test and supportive measures, the patient continued to deteriorate requiring critical care admission for ionotropic support, non‐invasive ventilation in addition to presumptive broad‐spectrum antimicrobial management. There was no significant improvement with supportive care until the presentation of multisystem involvement on in the context of a recent history of COVID 19 and negative infective screen was raised. The diagnosis of multisystem inflammatory syndrome‐adult form (MIS‐A) was embraced, and the patient was commenced on methylprednisolone leading to a dramatic resolution of symptoms both clinically and biochemically with stabilization of vital functions allowing for safe outcomes.Ahmad Al BishawiMaisa AliKhaled Al‐ZubaidiHamad AbdelhadiWileyarticleCOVID‐19cytokine stormMIS‐ASARS‐CoV‐2sepsisMedicineRMedicine (General)R5-920ENClinical Case Reports, Vol 9, Iss 11, Pp n/a-n/a (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID‐19 cytokine storm MIS‐A SARS‐CoV‐2 sepsis Medicine R Medicine (General) R5-920
spellingShingle	COVID‐19 cytokine storm MIS‐A SARS‐CoV‐2 sepsis Medicine R Medicine (General) R5-920 Ahmad Al Bishawi Maisa Ali Khaled Al‐Zubaidi Hamad Abdelhadi Beware of the ambiguous enemy of multisystem inflammatory syndrome in adult (MIS‐A) following Covid‐19 infection or vaccination
description	Abstract Multisystem Inflammatory Syndrome is a rare and novel clinical presentation described during the evolving COVID‐19 pandemic. The condition is usually presenting as a sepsis‐like syndrome leading to secondary multi‐organ dysfunction post–COVID‐19 infection. Although the syndrome has been mainly described in children, rare adults' form has been similarly described. We are describing a 37‐year‐old female patient presented with fever and neck pain after 1 month of a mild SARS‐CoV‐2 infection course and 10 days post her second COVID‐19 vaccine. Examination demonstrated fever, hypotension, and hypoxemia, in addition to multiple tender cervical lymph nodes. Initial laboratory workup showed evidence of significant inflammation with raised markers, including C‐reactive protein, ferritin, and interleukin‐6. Extensive evaluation to rule out active infection was done, and all return negative, including repeat SARS‐CoV‐2 test. Furthermore, cardiac evaluation showed moderately reduced systolic ventricular function. Despite all negative test and supportive measures, the patient continued to deteriorate requiring critical care admission for ionotropic support, non‐invasive ventilation in addition to presumptive broad‐spectrum antimicrobial management. There was no significant improvement with supportive care until the presentation of multisystem involvement on in the context of a recent history of COVID 19 and negative infective screen was raised. The diagnosis of multisystem inflammatory syndrome‐adult form (MIS‐A) was embraced, and the patient was commenced on methylprednisolone leading to a dramatic resolution of symptoms both clinically and biochemically with stabilization of vital functions allowing for safe outcomes.
format	article
author	Ahmad Al Bishawi Maisa Ali Khaled Al‐Zubaidi Hamad Abdelhadi
author_facet	Ahmad Al Bishawi Maisa Ali Khaled Al‐Zubaidi Hamad Abdelhadi
author_sort	Ahmad Al Bishawi
title	Beware of the ambiguous enemy of multisystem inflammatory syndrome in adult (MIS‐A) following Covid‐19 infection or vaccination
title_short	Beware of the ambiguous enemy of multisystem inflammatory syndrome in adult (MIS‐A) following Covid‐19 infection or vaccination
title_full	Beware of the ambiguous enemy of multisystem inflammatory syndrome in adult (MIS‐A) following Covid‐19 infection or vaccination
title_fullStr	Beware of the ambiguous enemy of multisystem inflammatory syndrome in adult (MIS‐A) following Covid‐19 infection or vaccination
title_full_unstemmed	Beware of the ambiguous enemy of multisystem inflammatory syndrome in adult (MIS‐A) following Covid‐19 infection or vaccination
title_sort	beware of the ambiguous enemy of multisystem inflammatory syndrome in adult (mis‐a) following covid‐19 infection or vaccination
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/72c325cd26af400f84bd62e19a5f6a7e
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Beware of the ambiguous enemy of multisystem inflammatory syndrome in adult (MIS‐A) following Covid‐19 infection or vaccination

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