(HealthDay News) — Adult patients with current or previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can develop a hyperinflammatory syndrome, which resembles multisystem inflammatory syndrome in children (MIS-C), according to a case series published in the US Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

Sapna Bamrah Morris, MD, from the CDC COVID-19 Response Team, and colleagues present reports of 27 patients with cardiovascular, gastrointestinal, dermatologic, and neurologic symptoms without severe respiratory illness who concurrently received positive test results for SARS-CoV-2.

The researchers highlight recognition of multisystem inflammatory syndrome in adults (MIS-A), which resembles MIS-C. The patients described had minimal respiratory symptoms, hypoxemia, or radiographic abnormalities. In case reports describing MIS-A, only 8 of 16 patients had any documented respiratory symptoms before onset of MIS-A. All 16 patients had evidence of cardiac effects, 13 had gastrointestinal symptoms on admission, and 5 had dermatologic manifestations. Ten of the patients had pulmonary ground-glass opacities, and 6 had pleural effusions on chest imaging, despite minimal respiratory symptoms. Ten of the patients had positive SARS-CoV-2 polymerase chain reaction (PCR) test results at the time of initial assessment. Six had negative SARS-CoV-2 PCR results, but 4 had positive anti-SARS-CoV-2 antibody results and 2 had positive SARS-CoV-2 PCR test results between 14 and 37 days before admission.

“Clinical suspicion and indicated SARS-CoV-2 testing, including antibody testing, might be needed to recognize and treat adults with MIS-A. Further research is needed to understand the pathogenesis and long-term effects of this condition,” the authors write. “Ultimately, the recognition of MIS-A reinforces the need for prevention efforts to limit spread of SARS-CoV-2.”


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Several authors disclosed financial ties to the pharmaceutical industry.

Reference

Morris SB, Schwartz NG, Patel P, et al. Case series of multisystem inflammatory syndrome in adults associated with SARS-CoV-2 infection — United Kingdom and United States, March–August 2020 Early Release / October 2, 2020 / 69