(HealthDay News) — Multisystem inflammatory syndrome in adults (MIS-A) presents about 4 weeks postacute COVID-19 with heterogeneous clinical symptoms, according to research published online in JAMA Network Open.

Pragna Patel, MD, from the US Centers for Disease Control and Prevention in Atlanta, and colleagues conducted a systematic review to identify reports of MIS-A either in the literature or from the US Centers for Disease Control and Prevention surveillance system.

The researchers identified 221 patients with MIS-A (median age, 21 years; 70% men). Just over one-third of cases (36%) were non-Hispanic Black individuals, and 58% had no underlying comorbidity. More than two-thirds (68%) noted a previous symptomatic COVID-19-like illness a median of 28 days previously. Most common presentations included fever (96%), hypotension (60%), cardiac dysfunction (54%), shortness of breath (52%), and diarrhea (52%). Cases had a median of 5 organ systems involved and had a median hospital stay of 8 days. More than half of cases (57%) were admitted to the intensive care unit, with 47% requiring respiratory support and 7% dying. The majority of patients (90%) had elevated markers of coagulopathy and/or inflammation and a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serologic finding (72%).

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“It is important for the clinical and public health community to suspect and identify MIS-A, a delayed immunologic response to SARS-CoV-2 infection in adults with hyperinflammation, by exercising clinical acumen and considering empirical treatment to reduce related morbidity and mortality,” the authors write.

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