scholarly journals SARS-CoV-2-related Multisystem Inflammatory Syndrome in Adults

2021 ◽  
Author(s):  
Antonio Martins ◽  
Sílvia Policarpo ◽  
André Silva Pinto ◽  
Ana Sofia Santos ◽  
Paulo Figueiredo ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Cardiac Dysfunction ◽  
Inflammatory Markers ◽  
Organ Involvement ◽  
Blood Tests ◽  
Inflammatory Syndrome ◽  
Pcr Test

Adults infected with SARS-CoV-2 may develop a multisystem inflammatory syndrome (MIS-A) characterized by elevated inflammatory markers and multisystem organ involvement. We report the case of a patient who presented with fever and vomiting at hospital admission. He tested positive for SARS-CoV-2 infection and blood tests showed elevated inflammatory markers. The patient developed acute cardiac dysfunction and shock in less than 24 hours and the echocardiogram revealed an LVEF of 30%. He was discharged 3 weeks later fully recovered. MIS-A should be considered if a compatible syndrome is observed in patients with evidence of SARS-CoV-2 infection by PCR test or serology.

scholarly journals Giant coronary artery aneurysm as a feature of coronavirus-related inflammatory syndrome

2021 ◽  
Vol 14 (7) ◽  
pp. e238740
Author(s):  
Kerrie Louise Richardson ◽  
Ankita Jain ◽  
Jennifer Evans ◽  
Orhan Uzun
Keyword(s):  
Coronary Artery ◽  
Inflammatory Markers ◽  
Coronary Artery Aneurysm ◽  
Artery Aneurysm ◽  
First Line ◽  
Coronary Artery Aneurysms ◽  
Giant Coronary Artery Aneurysm ◽  
History Of ◽  
Inflammatory Syndrome ◽  
Pcr Test

A 5-month-old female infant was admitted to hospital with a history of fever and rash during the recent coronavirus pandemic. She had significantly elevated inflammatory markers and the illness did not respond to first line broad spectrum antibiotics. The illness was later complicated by coronary artery aneurysms which were classified as giant despite treatment with intravenous immunoglobulin, steroids and immunomodulators. The infant had COVID-19 antibodies despite an initial negative COVID-19 PCR test. This case highlights the association of atypical Kawasaki like illness and paediatric multisystem inflammatory syndrome-temporarily associated with COVID-19 infection.

scholarly journals Infliximab in treatment of refractory multisystem inflammatory syndrome in children with severe cardiac dysfunction

2021 ◽  
Vol 0 (0) ◽  
pp. 0
Author(s):  
BhaktiU Sarangi ◽  
GuruprasadHassan Shankar ◽  
JitendraS Oswal ◽  
Ajay Walimbe ◽  
Prithvichandra Markal ◽  
...  
Keyword(s):  
Cardiac Dysfunction ◽  
Inflammatory Syndrome

Cancer therapy-related cardiac dysfunction: is endothelial dysfunction at the heart of the matter?

2021 ◽  
Vol 135 (12) ◽  
pp. 1487-1503
Author(s):  
Crizza Ching ◽  
Dakota Gustafson ◽  
Paaladinesh Thavendiranathan ◽  
Jason E. Fish
Keyword(s):  
Cancer Therapy ◽  
Cardiac Dysfunction ◽  
Inflammatory Markers ◽  
Cancer Survival ◽  
Growth Factor Receptor ◽  
Cardiovascular Effects ◽  
Cardiovascular Complications ◽  
Cardiac Biomarkers ◽  
Cancer Therapies ◽  
The Impact

Abstract Significant improvements in cancer survival have brought to light unintended long-term adverse cardiovascular effects associated with cancer treatment. Although capable of manifesting a broad range of cardiovascular complications, cancer therapy-related cardiac dysfunction (CTRCD) remains particularly common among the mainstay anthracycline-based and human epidermal growth factor receptor-targeted therapies. Unfortunately, the early asymptomatic stages of CTRCD are difficult to detect by cardiac imaging alone, and the initiating mechanisms remain incompletely understood. More recently, circulating inflammatory markers, cardiac biomarkers, microRNAs, and extracellular vesicles (EVs) have been considered as early markers of cardiovascular injury. Concomitantly, the role of the endothelium in regulating cardiac function in the context of CTRCD is starting to be understood. In this review, we highlight the impact of breast cancer therapies on the cardiovascular system with a focus on the endothelium, and examine the status of circulating biomarkers, including inflammatory markers, cardiac biomarkers, microRNAs, and endothelial cell-derived EVs. Investigation of these emerging biomarkers may uncover mechanisms of injury, detect early stages of cardiovascular damage, and elucidate novel therapeutic approaches.

scholarly journals A young adult with COVID-19 and multisystem inflammatory syndrome in children (MIS-C)-like illness: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Aaron D. Kofman ◽  
Emma K. Sizemore ◽  
Joshua F. Detelich ◽  
Benjamin Albrecht ◽  
Anne L. Piantadosi
Keyword(s):  
Cardiac Dysfunction ◽  
Clinical Characteristics ◽  
Kidney Injury ◽  
Clinical Findings ◽  
Low Grade ◽  
Rare Form ◽  
Case Presentation ◽  
Lymph Node Swelling ◽  
Inflammatory Syndrome

Abstract Background A healthy 25-year-old woman developed COVID-19 disease with clinical characteristics resembling Multisystem Inflammatory Syndrome in Children (MIS-C), a rare form of COVID-19 described primarily in children under 21 years of age. Case presentation The patient presented with 1 week of weakness, dyspnea, and low-grade fevers, followed by mild cough, sore throat, vomiting, diarrhea, and lymph node swelling. She was otherwise healthy, with no prior medical history. Her hospital course was notable for profound acute kidney injury, leukocytosis, hypotension, and cardiac dysfunction requiring ICU admission and vasopressor support. MIS-C-like illness secondary to COVID-19 was suspected due to physical exam findings of conjunctivitis, mucositis, and shock. She improved following IVIG, aspirin, and supportive care, and was discharged on hospital day 5. Conclusion MIS-C-like illness should be considered in adults presenting with atypical clinical findings and concern for COVID-19. Further research is needed to support the role of IVIG and aspirin in this patient population.

A Review of Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19

2020 ◽  
Vol 24 (4) ◽  
Author(s):  
Alireza Ghodsi ◽  
Abdolreza Malek ◽  
Sara Ghahremani
Keyword(s):  
Clinical Presentation ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Organ Involvement ◽  
High Morbidity ◽  
Laboratory Findings ◽  
Persistent Fever ◽  
Number Of Children ◽  
Relevant Evidence ◽  
Inflammatory Syndrome

: The coronavirus disease 2019 (COVID-19) pandemic, with a high morbidity and mortality rate, has affected all age groups. COVID-19 infection in children usually has minimal symptoms, but the number of children with the inflammatory syndrome with clinical features similar to the Kawasaki disease has increased during the COVID-19 pandemic. Information about this emerging COVID-19 manifestation also called the multisystem inflammatory syndrome in children (MIS-C), is still incomplete. Patients typically present with persistent fever, followed by shock or multi-organ involvement. Laboratory findings and clinical presentation of this multi-organ involvement is part of the diagnostic criteria. Early treatment and multidisciplinary referral to pediatric specialists are essential. The prognosis of MIS-C is not yet fully understood. Although most children survive, several deaths have also been reported. Based on relevant evidence, this study aimed to review the pathophysiology, clinical manifestations, laboratory and imaging findings, diagnosis, treatment recommendations, and prognosis of MIS-C associated with COVID-19.

scholarly journals The Inflammatory Markers of Multisystem Inflammatory Syndrome in children (MIS-C) and Adolescents During the COVID-19 Pandemic: A Meta-Analysis

2021 ◽  
Author(s):  
Yan Zhao ◽  
Li-juan Yin ◽  
Jenil Patel ◽  
Lei Tang ◽  
Ying Huang
Keyword(s):  
Inflammatory Markers ◽  
Meta Analysis ◽  
Absolute Lymphocyte Count ◽  
Older Children ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Quality Check ◽  
Inflammatory Syndrome ◽  
D Dimer

Abstract As per the indicated need in literature, we conducted a systematic review and meta-analysis to characterize inflammatory markers of MIS-C patients with COVID-19, Kawasaki disease (KD), and coronary artery abnormalities. We searched nine databases for studies on inflammatory markers of MIS-C. After quality check, data were pooled using a fixed- or random-effects model. Inflammatory markers included white blood cell count (WBC) or leukocytes, absolute lymphocyte count (ALC), absolute neutrophil count (ANC), platelet count (PLT), C-reactive protein (CRP), procalcitonin (PCT), ferritin, D-dimer, lactate dehydrogenase (LDH), fibrinogen and erythrocyte sedimentation rate (ESR) for comparisons by severity and age. Twenty studies with 2,990 participants yielded 684 MIS-C patients. Compared to non-severe COVID-19 patients, MIS-C patients had lower ALC and higher ANC, CRP and D-dimer levels. Compared to severe COVID-19 patients, MIS-C patients had lower LDH and PLT counts and higher ESR levels. Compared to KD patients, MIS-C patients had lower ALC and PLT, and higher CRP and ferritin levels. Severe MIS-C patients had higher levels of WBC, CRP, D-dimer and ferritin. For MIS-C, younger children had lower CRP and ferritin levels than medium-aged/older children. Measurement of inflammatory markers might assist clinicians in accurate evaluation and diagnosis of MIS-C and the associated disorders.

scholarly journals Cardiovascular findings in Echocardiography in post Covid-19 mild infection population in Argentina

2021 ◽  
Author(s):  
Carolina Torres Bianqui ◽  
Abigail Cueto ◽  
Romina Soto ◽  
Pablo Urbano ◽  
Agustina Amenabar ◽  
...  
Keyword(s):  
Left Ventricular Mass Index ◽  
Cardiac Involvement ◽  
Care Center ◽  
Left Ventricular ◽  
Healthy Individuals ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Inflammatory Syndrome ◽  
Echocardiographic Findings ◽  
Pcr Test

Objectives: The aim of this study was to assess differences in echocardiographic findings between a normal adult and a post Covid-19 population. Background: Coronavirus disease (Covid-19) is known to produce a systemic inflammatory syndrome, with pulmonary and cardiac involvement. However, the cardiovascular impact in patients with mild clinical forms of the disease is uncertain. There is small evidence supporting the finding of global ventricular longitudinal strain (GLS) alterations in these patients. Methods: One hundred and five consecutive patients admitted to an ambulatory care center, underwent a conventional transthoracic echocardiographic (TTE) study with acquisition of GLS. Patients were included if they underwent a positive diagnostic reverse transcriptase polymerase chain reaction (PCR) test, having no relevant preexisting conditions, with exception of obesity. Demographic and clinical data were prospectively obtained. For this purpose, we considered a normal cut off point of -17,09%, based on previous studies. Echocardiographic findings were compared with those of 67 healthy individuals. Results: Out of 172 patients, 105 correspond to Covid-19 group, and 67 to healthy individuals. There were no significant differences in GLS regarding age, left ventricular mass index (LVMI) and E/e’ ratio. The multivariate analysis showed that the percentage of patients with pathological GLS values was significantly higher within the Covid-19 and male groups (OR 6.02 IC 1.88-22.57; p 0.004 and OR 3.17 IC 1.03-10.50; p 0.05, respectively). Conclusion: These data support that Covid-19 infection could affect ventricular GLS and encourage the use of conventional TTE with GLS measurements in patients with non-significant forms of the disease.

scholarly journals A Case of Multisystem Inflammatory Syndrome in Children Presenting as Acute Appendicitis and Pancreatitis

PRILOZI ◽  
2021 ◽  
Vol 42 (2) ◽  
pp. 95-101
Author(s):  
Lidija Kareva ◽  
Katarina Stavrik ◽  
Kristina Mironska ◽  
Arjeta Hasani ◽  
Sonja Bojadzieva ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Pediatric Patients ◽  
Close Contact ◽  
Multiorgan Failure ◽  
Gastrointestinal Symptoms ◽  
Gastrointestinal Diseases ◽  
Serological Testing ◽  
Inflammatory Syndrome ◽  
Pcr Test

Abstract Multisystem Inflammatory Syndrome in Children (MIS-C) is characterized by an inflammation with fever, elevated inflammatory markers, conjunctivitis, rash, impaired coagulation, gastrointestinal symptoms and cardiac abnormalities that may progress to multiorgan failure. The presence of a positive COVID-19 antigen via a PCR test, serological testing for antibodies or close contact with a person diagnosed with COVID-19 helps differentiate MIS-C from other diseases. Gastrointestinal symptoms are recognized to be associated with COVID-19 infection or MIS-C in children, presenting as abdominal pain, gastrointestinal infection with watery stools, appendicitis, ileitis, pancreatitis and hepatitis, confusing the diagnosis with other gastrointestinal diseases. In this case report, we describe an 11 year old boy with MIS-C, who presents acute phlegmona of the appendix for which he undergoes appendectomy, accompanied with acute pancreatitis. These manifestations of MIS-C in our patient resolved without additional complications after a 2 month follow up. We call attention to MIS-C presenting in pediatric patients with fever and abdominal pain which might be caused by appendicitis and pancreatitis, and we recommend abdominal imaging and additional laboratory investigation to promote earlier diagnosis.

scholarly journals Clinical Characteristics and Factors Associated with Unfavorable Outcomes of Pediatric Inflammatory Multisystem Syndrome Related to COVID-19 in Lima-Peru

2021 ◽  
Author(s):  
Olguita del Aguila ◽  
Jesús Dominguez-Rojas ◽  
Kenny Chonlon-Murillo ◽  
Aida Borcic ◽  
Sandra Sánchez ◽  
...  
Keyword(s):  
Inflammatory Markers ◽  
Myocardial Injury ◽  
Coronary Aneurysm ◽  
C Reactive Protein ◽  
Factors Associated ◽  
Reactive Protein ◽  
Robust Variance ◽  
Organic Dysfunction ◽  
Epidemiological Profile ◽  
Inflammatory Syndrome

Abstract Objective: Describe the clinical-epidemiological profile and determine the factors associated with unfavorable outcomes of pediatrics multisystemic inflammatory syndrome (SIM-P) related to COVID-19 at Edgardo Rebagliati Martins National Hospital (HNERM), Lima-Perú, from April to September 2020. Materials and methods: Retrospective cohort in children under 14 years of age. The current criteria were used for the diagnosis of SIM-P. The effect size was estimated with relative risk (RR) and 95% confidence intervals, using a generalized linear Poisson family model with robust variance. Results: 43 patients were included, 22 (51.2%) Kawasaki Disease (EK), 10 (23.3%) shock, and 11(25.6%) fever with inflammatory markers. The median age was 8 years, most men, without comorbidity, with negative molecular test and positive IgG. Gastrointestinal and mucocutaneous manifestations predominated, with altered inflammatory markers and myocardial injury. Most required intravenous immunoglobulin (IVIG), aspirin (AAS), corticosteroids and antibiotics. More than a third required VMI, ICU and developed organic dysfunction, with a lethality of 4.6% (2/43). Increasing lethality to 20% (2/10) in the shock subgroup. Five were found (14.7%) coronary aneurysm. Having some comorbidity (RR 1.79; IC95%1.02-3.14), C-reactive protein ≥ 10 mg/dL (RR 2.09; IC95%1.15-3.79), and SatO2 ≤92 in emergency (RR 2.84; IC95%1.47-5.50) was morelikely to betransferred to ICU. In addition, those with some comorability (RR 2.23; IC95%1.04-4.79), with lymphopenia <500cel/mL (RR 2.8; IC95%1.24-6.30), and with d≥ 3 mg/L (RR 3.57; IC95%1.23-10.38) were more likely to require VMI. Conclusion: Active monitoringis an eye to make early diagnosis and management in order to improve the prognosis.

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