scholarly journals Varying Presentations of Multisystem Inflammatory Syndrome Temporarily Associated with COVID-19

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Jasmina Krikilion ◽  
Lisa Nuyttens ◽  
Siel Daelemans ◽  
Karlien François ◽  
Reiner Mauel ◽  
...  
Keyword(s):  
Distress Syndrome ◽  
Early Recognition ◽  
Clinical Manifestations ◽  
Toxic Shock ◽  
Clinical Presentations ◽  
Atypical Kawasaki Disease ◽  
Case Presentations ◽  
Novel Coronavirus ◽  
Inflammatory Syndrome ◽  
Beneficial Outcome

Background. A novel coronavirus identified in 2019 leads to a pandemic of severe acute respiratory distress syndrome with important morbidity and mortality. Initially, children seemed minimally affected, but there were reports of cases similar to (atypical) Kawasaki disease or toxic shock syndrome, and evidence emerges about a complication named paediatric inflammatory multisystem syndrome temporarily associated with SARS-CoV-2 (PIMS-TS) or multisystem inflammatory syndrome in children (MIS-C). Case Presentations. Two cases were compared and discussed demonstrating varying presentations, management, and evolution of MIS-C. These cases are presented to increase awareness and familiarity among paediatricians and emergency physicians with the different clinical manifestations of this syndrome. Discussion. MIS-C may occur with possible diverse clinical presentations. Early recognition and treatment are paramount for a beneficial outcome.

scholarly journals COVID-19 Associated Multisystem Inflammatory Syndrome: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Ashkan Baradaran ◽  
Abdolreza Malek ◽  
Nasrin Moazzen ◽  
Zahra Abbasi Shaye
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Gastrointestinal Symptoms ◽  
Multiple Organ ◽  
Current Evidence ◽  
Cardiac Complications ◽  
Clinical Presentations ◽  
Atypical Kawasaki Disease ◽  
Novel Coronavirus ◽  
Inflammatory Syndrome

The prevalence of multisystem inflammatory syndrome in children (MIS-C) has increased since the coronavirus disease 2019 (COVID-19) pandemic started. This study was aimed to describe clinical manifestation and outcomes of MIS-C associated with COVID-19. This systematic review and meta-analysis were conducted on all available literature until July 3rd, 2020. The screening was done by using the following keywords: (“novel coronavirus” Or COVID-19 or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus) and ("MIS-C" or "multisystem inflammatory" or Kawasaki). Data on gender, ethnicity, clinical presentations, need for mechanical ventilation or admission to intensive care unit (ICU), imaging, cardiac complications, and COVID-19 laboratory results were extracted to measure the pooled estimates. Out of 314 found articles, 16 articles with a total of 600 patients were included in the study, the most common presentation was fever (97%), followed by gastrointestinal symptoms (80%), and skin rashes (60%) as well as shock (55%), conjunctivitis (54%), and respiratory symptoms (39%). Less common presentations were neurologic problems (33%), and skin desquamation (30%), MIS-C was slightly more prevalent in males (53.7%) compared to females (46.3%). The findings of this meta-analysis on current evidence found that the common clinical presentations of COVID-19 associated MIS-C include a combination of fever and mucocutaneous involvements, similar to atypical Kawasaki disease, and multiple organ dysfunction. Due to the relatively higher morbidity and mortality rate, it is very important to diagnose this condition promptly.  

scholarly journals Antibody responses to SARS-CoV2 are distinct in children with MIS-C compared to adults with COVID-19

2020 ◽  
Author(s):  
Stuart P Weisberg ◽  
Thomas Connors ◽  
Yun Zhu ◽  
Matthew Baldwin ◽  
Wen-Hsuan Lin ◽  
...  
Keyword(s):  
Distress Syndrome ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Serological Response ◽  
The Novel ◽  
N Protein ◽  
Mild Disease ◽  
Patient Groups ◽  
Novel Coronavirus ◽  
Inflammatory Syndrome

Clinical manifestations of COVID-19 caused by the novel coronavirus SARS-CoV-2 are associated with age. While children are largely spared from severe respiratory disease, they can present with a SARS-CoV-2-associated multisystem inflammatory syndrome (MIS-C) similar to Kawasaki's disease. Here, we show distinct antibody (Ab) responses in children with MIS-C compared to adults with severe COVID-19 causing acute respiratory distress syndrome (ARDS), and those who recovered from mild disease. There was a reduced breadth and specificity of anti-SARS-CoV-2-specific antibodies in MIS-C patients compared to the COVID patient groups; MIS-C predominantly generated IgG Abs specific for the Spike (S) protein but not for the nucleocapsid (N) protein, while both COVID-19 cohorts had anti-S IgG, IgM and IgA Abs, as well as anti-N IgG Abs. Moreover, MIS-C patients had reduced neutralizing activity compared to COVID-19 cohorts, indicating a reduced protective serological response. These results suggest a distinct infection course and immune response in children and adults who develop severe disease, with implications for optimizing treatments based on symptom and age.

scholarly journals Dermatological Manifestations of COVID-19 in Children

2020 ◽  
Vol 7 (2) ◽  
Author(s):  
Vivek Athwani ◽  
Sunil Gothwal
Keyword(s):  
Toxic Shock Syndrome ◽  
Gastrointestinal Symptoms ◽  
Skin Lesions ◽  
Skin Involvement ◽  
Toxic Shock ◽  
Cutaneous Manifestations ◽  
Systemic Involvement ◽  
Atypical Kawasaki Disease ◽  
Coronavirus Infection ◽  
Inflammatory Syndrome

: Coronavirus infection 2019 (COVID-19) primarily has a respiratory system and multi-systemic involvement. Respiratory and gastrointestinal symptoms are predominantly seen in children. In adults, few COVID-19 cases are reported with cutaneous manifestations. Although children are less severely affected by COVID-19, there is increasing evidence for skin involvement, which is in the form of chilblain (e.g., lesions, vesicular, and maculopapular) and erythema multiforme (e.g., rash). Also, few COVID-19 cases are presented with a clinical picture of atypical Kawasaki disease and toxic shock syndrome, later defined as pediatric multisystem inflammatory syndrome (PMIS). The present study aims to summarize various skin lesions with COVID-19.

scholarly journals Grade 4 Pneumonitis in a Patient Treated with a Combination of Gemcitabine and Docetaxel for Recurrent Leiomyosarcoma of the Uterus

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Connor Wang ◽  
Stephen Rose ◽  
Lori Mankowski Gettle ◽  
Ryan Spencer
Keyword(s):  
Distress Syndrome ◽  
Early Recognition ◽  
Standard Of Care ◽  
Diffuse Alveolar Hemorrhage ◽  
Uterine Leiomyosarcoma ◽  
Early Administration ◽  
Radiographic Findings ◽  
Clinical Presentations ◽  
Life Threatening ◽  
Treatment Responses

Gemcitabine and docetaxel combination chemotherapy is the standard of care for patients with unresectable recurrent or metastatic leiomyosarcoma of the uterus. Although they are generally well-tolerated agents, they can also cause severe and life-threatening pulmonary toxicities. Here, we describe a case of grade 4 pneumonitis due to gemcitabine and docetaxel in a 74-year-old woman with recurrent, metastatic uterine leiomyosarcoma. Despite early recognition of chemotherapy-induced lung injury and early administration of corticosteroid, she developed noncardiogenic pulmonary edema, diffuse alveolar hemorrhage, and acute respiratory distress syndrome. She required multiple intubations and a tracheostomy. Physicians should not only be aware of gemcitabine and docetaxel’s potential to cause life-threatening pulmonary injuries but also recognize the variability in clinical presentations and treatment responses, the radiographic findings of these lung toxicities, and the need for early corticosteroid therapy in these cases.

SARS-CoV-2 and COVID-19

2021 ◽  
Author(s):  
Rosalind Hollingsworth
Keyword(s):  
Distress Syndrome ◽  
Multiorgan Failure ◽  
Mainland China ◽  
Respiratory Illness ◽  
Infected Person ◽  
Increased Risk ◽  
Asymptomatic Infections ◽  
Novel Coronavirus ◽  
Inflammatory Syndrome ◽  
Respiratory Droplets

Coronavirus disease 19 (COVID-19) is a respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus which emerged in Wuhan, China in 2019, and from there spread to other parts of mainland China and around the world. The virus spreads mainly through respiratory droplets produced when an infected person coughs, sneezes, or speaks. On average, the time from exposure to SARS-CoV-2 to the appearance of symptoms is 5–6 days but can range from 1–14 days. Asymptomatic infections with SARS-CoV-2 can occur. In those with symptoms, most people (approx. 80%) will experience a mild to moderate respiratory illness and recover without hospital management. Adults 65 years of age and older, and individuals of any age with underlying medical conditions, are at increased risk for severe COVID-19 and death. Complications include respiratory failure, acute respiratory distress syndrome, sepsis/septic shock, thromboembolism, multiorgan failure and death. In rare cases, children and adults can develop a severe inflammatory syndrome a few weeks after SARS-COV-2 infection. Vaccines are available to help prevent COVID-19 disease; by August 2021, 7 vaccines had been authorized for use by the WHO to prevent COVID-19 caused by SARS-CoV-2, with others approved by country regulatory authorities.

scholarly journals Case Report: MIS-C Temporarily Associated With COVID-19 Complicated by Reye's Syndrome

2021 ◽  
Vol 9 ◽  
Author(s):  
Fabrício Silva Pessoa ◽  
Eliza Maria da Costa Brito Lacerda ◽  
Valdênia Costa Gonçalves ◽  
Barbara Neiva Tanaka
Keyword(s):  
Case Report ◽  
Acetylsalicylic Acid ◽  
Clinical Manifestations ◽  
Coronary Aneurysm ◽  
Human Immunoglobulin ◽  
The Novel ◽  
Reye's Syndrome ◽  
Serious Illness ◽  
Novel Coronavirus ◽  
Inflammatory Syndrome

We describe a 7-year-old child with multisystemic inflammatory syndrome that was temporarily associated with the novel coronavirus disease which evolved into serious illness, with coronary aneurysm, using human immunoglobulin and acetylsalicylic acid, in which clinical manifestations including hepatitis, convulsions, and coma were aggravated with Reye's syndrome. To date, there has been no report of the association of multisystemic inflammatory syndrome that is temporarily associated with the novel coronavirus disease and Reye's syndrome.

scholarly journals Multisystemic Inflammatory Syndrome and Thrombotic Microangiopathy as Complications of COVID-19 in a Child: A Case Report

2021 ◽  
Vol 9 ◽  
Author(s):  
Samira Shizuko Parreão Oi ◽  
Monique Pereira Rêgo Muniz ◽  
Igor Murad Faria ◽  
Natalino Salgado Filho ◽  
Dyego José Araújo de Brito ◽  
...  
Keyword(s):  
Thrombotic Microangiopathy ◽  
Kidney Injury ◽  
Significant Prognostic Factor ◽  
The Novel ◽  
Fatal Disease ◽  
Clinical Complications ◽  
Clinical Presentations ◽  
Nephritic Syndrome ◽  
Novel Coronavirus ◽  
Inflammatory Syndrome

Clinical presentations of the novel coronavirus (SARS-CoV-2) infection are quite varied, ranging from asymptomatic conditions to potentially fatal disease. The kidney is one of the affected targets of coronavirus disease (COVID-19) complications, and renal dysfunction is a significant prognostic factor for mortality. This report describes a series of clinical complications in a previously healthy child who developed nephritic syndrome with a concomitant SARS-CoV-2 infection. These complications include acute kidney injury that progressed to chronicity, multisystemic inflammatory syndrome, Kawasaki-like syndrome, and thrombotic microangiopathy.

Acute Respiratory Distress Syndrome (ARDS) Caused by the Novel Coronavirus Disease (COVID-19): A Practical Comprehensive Literature Review

2020 ◽  
Author(s):  
Francisco Montenegro ◽  
Luis Unigarro ◽  
Gustavo Paredes ◽  
Tatiana Moya ◽  
Ana Romero ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Literature Review ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Clinical Manifestations ◽  
The Novel ◽  
Comprehensive Literature Review ◽  
Wide Range ◽  
Novel Coronavirus

Introduction: The exponential growth of the SARS-CoV-2 virus transmission during the first months of 2020 has placed substantial pressure on health systems worldwide. The complications derived from the novel coronavirus disease (COVID-19) vary in due to comorbidities, sex and age, with more than 50% of the patients who require some level of intensive care developing acute respiratory distress syndrome (ARDS). Areas covered: Various complications caused by SARS-CoV-2 infection have been identified, the most lethal being the acute respiratory distress syndrome, caused most likely by the presence of severe immune cell response and the concomitant alveolus inflammation. The authors carried out an extensive and comprehensive literature review on SARS-CoV-2 infection, the clinical, pathological and radiological presentation as well as the current treatment strategies. Expert Opinion Elevation of inflammatory biomarkers is a common trend among seriously ill patients. The information available strongly suggests that in COVID-19 patients, their altered immune response, including a massive cytokine storm, is responsible for the further damage evidenced among ARDS patients. The increasingly high number of scientific articles and evidence available can only suggest that the individualization of each case is the norm, not all patients with acute respiratory failure due to COVID-19 meet the Berlin definition and therefore ARDS should be considered as a heterogeneous disease, with a wide range in the expression of its severity and clinical manifestations.

scholarly journals Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with 2019 Novel Coronavirus (SARS-CoV-2) Infection

2020 ◽  
Vol 2020 ◽  
pp. 1-4 ◽  
Author(s):  
Helen Kest ◽  
Ashlesha Kaushik ◽  
William DeBruin ◽  
Mario Colletti ◽  
David Goldberg
Keyword(s):  
Critically Ill ◽  
Care Center ◽  
Tertiary Care ◽  
Altered Mental Status ◽  
Reactive Protein ◽  
Clinical Presentations ◽  
Gastrointestinal Complaints ◽  
Novel Coronavirus ◽  
Inflammatory Syndrome ◽  
Csf Findings

We report three critically ill pediatric patients (aged 6–10 years), presenting with features of multisystem inflammatory syndrome in children (MIS-C) from April 4 to May 10, 2020, to a tertiary-care center in New Jersey, United States. All patients tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and were previously healthy. Clinical presentations were similar with fever, abdominal pain, gastrointestinal complaints, and/or rash. One patient had altered mental status with cerebrospinal fluid (CSF) findings consistent with aseptic meningitis. Laboratory values were remarkable for high levels of C-reactive protein, D-dimers, B-type natriuretic peptide (BNP), and troponin in all patients. All had low albumin levels. Evaluation for other infectious etiologies was negative. All of the patients were critically ill, requiring admission to the intensive care unit. All had circulatory shock and needed inotropes. Two patients had respiratory failure requiring advanced respiratory support and one had cardiac dysfunction. All patients received steroids, and two received intravenous immunoglobulin (IVIG). One patient received tocilizumab. None of the children died. MIS-C is a recently recognized pediatric illness spectrum in association with SARS-CoV-2 infection, and clinical characterization is essential for understanding disease mechanisms to inform clinical practice.

scholarly journals Multi-System Inflammatory Syndrome in a Child Mimicking Kawasaki Disease

2020 ◽  
Author(s):  
Aman Gupta ◽  
Arpinder Gill ◽  
Manu Sharma ◽  
Megha Garg
Keyword(s):  
Kawasaki Disease ◽  
Macrophage Activation Syndrome ◽  
Macrophage Activation ◽  
Early Recognition ◽  
Clinical Manifestations ◽  
Case Definitions ◽  
Laboratory Parameters ◽  
Life Saving ◽  
Inflammatory Syndrome ◽  
Activation Syndrome

Abstract There have been recent reports of children presenting with severe multi-system hyperinflammatory syndrome resembling Kawasaki disease (KD) during current COVID-19 pandemic. Exact pathophysiology is unknown, however, most of the children have multi-organ dysfunction and respiratory system involvement is less common compared to adults. These patients have certain characteristic laboratory parameters different from those seen in children with KD. However, only limited literature is available at present for identification and management of such patients. We report a young girl who presented with fever, rash and other manifestations mimicking classic KD and fulfilling the case definitions for pediatric multi-system inflammatory syndrome. She had lymphopenia, thrombocytopenia and hyponatremia in the absence of macrophage activation syndrome, similar to that seen in patients reported from UK and Italy. Clinical manifestations resolved and laboratory parameters improved with intravenous immunoglobulin and corticosteroids. Early recognition is important to administer immunomodulatory therapy which may be life saving for these patients.

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