Journal Article

Case Series of Multisystem Inflammatory Syndrome in Adults Associated with SARS-CoV-2 Infection — United Kingdom and United States, March–August 2020

Ende, Zachary, Belay, Ermias, Ballen, Vennus, Kofman, Aaron, Smith, Emer, Stogsdill, Patricia, Morris, Sapna Bamrah, Beauchamps, Laura, Eiras, Daniel P., Newton-Cheh, Christopher, Robinson, Sara, Balan, Shuba, Paneth-Pollak, Rachel, Abbo, Lilian, Lash, Maura K., Hand, Julie, Bryant, Bobbi, Dorsinville, Marie S., Geevarughese, Anita, Schwartz, Noah G., Lim, Sarah, Richardson, Gillian, Godfred-Cato, Shana, Fox, Sharon E., Patel, Pragna, Lee, Ellen H., Datta, Deblina, Oliver, Nora T.

2020

Overview

During the course of the coronavirus disease 2019 (COVID-19) pandemic, reports of a new multisystem inflammatory syndrome in children (MIS-C) have been increasing in Europe and the United States (1-3). Clinical features in children have varied but predominantly include shock, cardiac dysfunction, abdominal pain, and elevated inflammatory markers, including C-reactive protein (CRP), ferritin, D-dimer, and interleukin-6 (1). Since June 2020, several case reports have described a similar syndrome in adults; this review describes in detail nine patients reported to CDC, seven from published case reports, and summarizes the findings in 11 patients described in three case series in peer-reviewed journals (4-6). These 27 patients had cardiovascular, gastrointestinal, dermatologic, and neurologic symptoms without severe respiratory illness and concurrently received positive test results for SARS-CoV-2, the virus that causes COVID-19, by polymerase chain reaction (PCR) or antibody assays indicating recent infection. Reports of these patients highlight the recognition of an illness referred to here as multisystem inflammatory syndrome in adults (MIS-A), the heterogeneity of clinical signs and symptoms, and the role for antibody testing in identifying similar cases among adults. Clinicians and health departments should consider MIS-A in adults with compatible signs and symptoms. These patients might not have positive SARS-CoV-2 PCR or antigen test results, and antibody testing might be needed to confirm previous SARS-CoV-2 infection. Because of the temporal association between MIS-A and SARS-CoV-2 infections, interventions that prevent COVID-19 might prevent MIS-A. Further research is needed to understand the pathogenesis and long-term effects of this newly described condition.

• Publisher: U.S. Government Printing Office,U.S. Center for Disease Control,Centers for Disease Control and Prevention
• Subject: Adolescents / Adult / Adults / Antibodies / Antigens / C-reactive protein / Case reports / Children / Clinical medicine / Coronavirus Infections - complications / Coronavirus Infections - epidemiology / Coronaviruses / COVID-19 / Cytokines / Demographics / Ethnicity / Female / Ferritin / Full Report / Humans / Illnesses / Immunoglobulins / Infections / Inflammation / Intensive care / Interleukins / Long term / Long-term effects / Male / Medical laboratories / Middle Aged / Multisystem inflammatory syndrome in children / Pandemics / Pathogenesis / Patients / Pneumonia, Viral - complications / Pneumonia, Viral - epidemiology / Prevention programs / Public health / Respiratory diseases / Severe acute respiratory syndrome / Severe acute respiratory syndrome coronavirus 2 / Systemic Inflammatory Response Syndrome - diagnosis / Systemic Inflammatory Response Syndrome - virology / Tests / United Kingdom - epidemiology / United States - epidemiology / Young Adult / Young adults