HealthDay News — Multisystem inflammatory syndrome in adults (MIS-A) presents about four weeks postacute COVID-19 with heterogeneous clinical symptoms, according to research published online Sept. 22 in JAMA Network Open.
Pragna Patel, M.D., from the U.S. 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 U.S. Centers for Disease Control and Prevention surveillance system.
The researchers identified 221 patients with MIS-A (median age, 21 years; 70 percent men). Just over one-third of cases (36 percent) were non-Hispanic Black individuals, and 58 percent had no underlying comorbidity. More than two-thirds (68 percent) noted a previous symptomatic COVID-19-like illness a median of 28 days previously. Most common presentations included fever (96 percent), hypotension (60 percent), cardiac dysfunction (54 percent), shortness of breath (52 percent), and diarrhea (52 percent). Cases had a median of five organ systems involved and had a median hospital stay of eight days. More than half of cases (57 percent) were admitted to the intensive care unit, with 47 percent requiring respiratory support and 7 percent dying. The majority of patients (90 percent) had elevated markers of coagulopathy and/or inflammation and a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serologic finding (72 percent).
“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.