Journal Article

Identification and description of patients with multisystem inflammatory syndrome in adults associated with SARS-CoV-2 infection using the Premier Healthcare Database

Godfred-Cato, Shana, Baggs, James, Belay, Ermias D., DeCuir, Jennifer, Patel, Pragna, Wong, Karen K., Melgar, Michael, Schwartz, Noah G., Morris, Sapna Bamrah

2022

Overview

Multisystem inflammatory syndrome in adults (MIS-A) is a hyperinflammatory illness related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The characteristics of patients with this syndrome and the frequency with which it occurs among patients hospitalised after SARS-CoV-2 infection are unclear. Using the Centers for Disease Control and Prevention case definition for MIS-A, we created ICD-10-CM code and laboratory criteria to identify potential MIS-A patients in the Premier Healthcare Database Special COVID-19 Release, a database containing patient-level information on hospital discharges across the United States. Modified MIS-A criteria were applied to hospitalisations with discharge from March to December 2020. The proportion of hospitalisations meeting electronic health record criteria for MIS-A and descriptive statistics for patients in the potential MIS-A cohort were calculated. Of 34 515 SARS-CoV-2-related hospitalisations with complete clinical and laboratory data, 53 met modified criteria for MIS-A (0.15%). The median age was 62 years (IQR 52–74). Most patients met the severe cardiac illness criterion through either myocarditis (66.0%) or new-onset heart failure (35.8%). A total of 79.2% of patients required ICU admission, while 43.4% of patients in the cohort died. MIS-A appears to be a rare but severe outcome of SARS-CoV-2 infection. Additional studies are needed to investigate how this syndrome differs from severe coronavirus disease 2019 (COVID-19) in adults.

• Publisher: Cambridge University Press
• Subject: Adults / Aged / Cohort Studies / Congestive heart failure / Coronaviruses / COVID-19 / COVID-19 - complications / COVID-19 - diagnosis / COVID-19 - ethnology / COVID-19 - mortality / Criteria / Databases, Factual / Disease control / Electronic health records / Electronic medical records / Female / Health care / Humans / Illnesses / Inflammation / Inflammatory diseases / Intensive Care Units / Male / Middle Aged / Multiple organ dysfunction syndrome / Myocarditis / Original Paper / Patients / Respiratory diseases / Severe acute respiratory syndrome coronavirus 2 / Systemic Inflammatory Response Syndrome - diagnosis / Systemic Inflammatory Response Syndrome - ethnology / Systemic Inflammatory Response Syndrome - mortality / Viral diseases