Co-existence of multisystem inflammatory syndrome in children associated with COVID-19 and scrub typhus infection: a case series

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20214847 ◽

2021 ◽

Author(s):

Sarbani M. Roy ◽

Sushama Sahoo

Keyword(s):

Clinical Features ◽

Scrub Typhus ◽

Virus Disease ◽

Clinical Manifestations ◽

Case Series ◽

World Health ◽

Laboratory Findings ◽

Term Outcome ◽

Corona Virus ◽

Inflammatory Syndrome

We are in the midst of pandemic of corona virus disease (COVID-19), caused by the novel coronavirus severe acute respiratory syndrome corona virus-2 (SARS-CoV-2). A clinical entity with hyperinflammatory syndrome, defined by World Health Organization (WHO) as multisystem inflammatory syndrome in children (MIS-C) and adolescents, temporarily related to COVID-19, is being reported in this pandemic from several countries. MIS-C has overlapping clinical features of Kawasaki disease (KD). KD has been described in association with various organisms including dengue, scrub typhus. MIS-C with concomitant infection has rarely been reported in literature till date. We report on ten sick pediatric patients presented with clinical features of MIS-C, in whom diagnosis of concomitant scrub typhus were also made. This retrospective study was conducted in the department of pediatric medicine of a medical college, in a district town of West Bengal, India. SARS-CoV-2 immunoglobulin G level was elevated in all of them and they were also positive with Scrub typhus serology. We reviewed and analysed their basic informations, clinical manifestations, epidemiological history, laboratory findings, treatment and short term outcome. Median age was 24 months (range 4 months-8 years), male: female was 1:1. All the patients survived. Concomitant tropical infection in a patient with MIS-C may play an important role in determining the prognosis of such patients. Early detection and intervention will result in better management and intact survival of them.

Download Full-text

Case Report: Case Series of Children With Multisystem Inflammatory Syndrome Following SARS-CoV-2 Infection in Switzerland

Frontiers in Pediatrics ◽

10.3389/fped.2020.594127 ◽

2021 ◽

Vol 8 ◽

Author(s):

Athina Fouriki ◽

Yves Fougère ◽

Caroline De Camaret ◽

Géraldine Blanchard Rohner ◽

Serge Grazioli ◽

...

Keyword(s):

Clinical Features ◽

Toxic Shock Syndrome ◽

Case Series ◽

Serum Levels ◽

Intravenous Immunoglobulins ◽

Toxic Shock ◽

Laboratory Findings ◽

First Line Therapy ◽

Ivig Resistance ◽

Inflammatory Syndrome

Since the beginning of the severe SARS-CoV-2 pandemic, an increasing number of countries reported cases of a systemic hyperinflammatory condition defined as multi-system inflammatory syndrome in children (MIS-C). The clinical features of MIS-C can be an overlap of Kawasaki Disease (KD), Toxic Shock Syndrome (TSS), Macrophage Activation Syndrome (MAS), or have often an acute abdominal presentation. Intravenous immunoglobulin (IVIG) is recommended as first line therapy in KD. Recent evidence suggests intravenous immunoglobulins (IVIG) resistance in some cases of SARS-CoV-2 related MIS-C, thereby questioning the benefit of immunomodulators such as IL-1 or IL-6 blocking agents. We report on a cohort of 6 Swiss children with SARS-CoV2 related MIS-C presenting with clinical features compatible with Incomplete KD and Toxic Shock Syndrome associated to a cytokine storm. Serum cytokine profile investigations showed increased IL1RA levels (8 to 22-fold) in 5 of the 6 patients (one patient had not been tested), whereas, IL-6 serum levels were increased only in the 3 patients of the 6 who were tested. With exception of one patient who had only benefited by Anakinra, all patients received at least one dose of IVIG. One patient has only received Anakinra with favorable evolution, and three patients had also a steroid treatment. In addition to all this anti-inflammatory medication two patients have also received one dose of anti-IL6. In conclusion, our case series reports on clinical and laboratory findings of most of Swiss cases with MIS-C and suggests the use of Anakinra as an alternative to steroids in these children, most of whom presented with high IL-1RA levels.

Download Full-text

COVID-19 related multisystem inflammatory syndrome in children (MIS-C): a case series from a tertiary care pediatric hospital in Qatar

10.21203/rs.3.rs-124953/v1 ◽

2021 ◽

Author(s):

Mohammad Hasan ◽

Khaled Al Zubaidi ◽

Karim Diab ◽

Yahia Hejazi ◽

Sharon Bout-Tabaku ◽

...

Keyword(s):

Clinical Features ◽

Early Recognition ◽

Tertiary Care ◽

Case Series ◽

Case Definition ◽

Cardiac Biomarkers ◽

Medical Attention ◽

Laboratory Findings ◽

First Case ◽

Inflammatory Syndrome

Abstract Background: Multisystem Inflammatory Syndrome in Children (MIS-C) is a severe complication of coronavirus disease 2019 (COVID-19) in children, which is increasingly being reported worldwide. Here we report the first case series of 7 children diagnosed with MIS-C in Qatar. Methods: Clinical features and outcomes of COVID-19 positive patients admitted to Sidra Medicine, Qatar from June to October 2020, who met the WHO case definition for MIS-C were reviewed.Results: The mean age in our case series was 5.6 years, of which 71.4% were males. All patients were previously healthy but had a history of COVID-19 infection. Fever, rash, vomiting and abdominal pain were the most common symptoms (70%-100%). The average hospitalization was 12.9 days with no case fatalities. Laboratory findings included lymphopenia and thrombocytopenia in most patients, as well as evidence of coagulopathy and elevated inflammatory markers such as C-reactive protein, ferritin and procalcitonin. Many patients (71.4%) required inotropic support in intensive care, while only one required respiratory support. Although all patients had elevated cardiac biomarkers, cardiovascular involvement was observed in 42.9% of patients with one patient developing a giant coronary aneurysm. All patients received intravenous immunoglobulin (IVIG) and 86% of patients received corticosteroids, with two patients requiring treatment with IL-1 inhibitors.Conclusions: Our report is one of the first reports on MIS-C from Asia. Although clinical features and outcomes are not significantly different from those reported elsewhere, lack of case fatalities in our cohort may indicate that early recognition and prompt medical attention is necessary for a favorable outcome in MIS-C.

Download Full-text

Clinical course and disease outcomes in hospitalized patients with 2019 novel corona virus disease at Ibn- Al Khateeb Hospital in Baghdad, Iraq

Journal of the Faculty of Medicine Baghdad ◽

10.32007/jfacmedbagdad.6231775 ◽

2020 ◽

Vol 62 (3) ◽

Author(s):

Iman Ahmed Mohammed ◽

Abbas Hasan Ali ◽

Jaafer Naseer Al shenaty

Keyword(s):

Length Of Stay ◽

Virus Disease ◽

Clinical Signs ◽

Signs And Symptoms ◽

World Health ◽

Disease Outcome ◽

Laboratory Findings ◽

Cross Sectional ◽

Disease Outcomes ◽

Corona Virus

Background: the novel coronavirus (2019-ncov), formally known as severe acute respiratory syndrome coronavirus 2 (sars-cov-2), the etiological cause of the (corona virus disease 2019) covid-19, appeared in wuhan, hubei province, china. On 11 march 2020, the world health organization (who) declared this disease as a pandemic. As new information on the clinical characteristics, treatment options, and outcomes for covid-19 emerges approximately every hour, physicians should keep themselves up-to-date on this topic.Objective: to study the demographic features, clinical signs and symptoms and certain vital and laboratory findings of covid-19 hospitalized cases; and to identify the used medication, complications, length of stay at the hospital and disease outcomes of confirmed covid-19 cases.Patients and methods: a descriptive cross-sectional study with analytic elements was conducted at ibn-al khateeb hospital, baghdad on covid-19 patients admitted to the hospital from 1st of march to 4th of may 2020. All inpatients of all age groups, diagnosed as covid-19 and had a definite outcome (recovered and discharge or death) during the period of the study were included.Results: the mean age ± sd for the patients included in the study was = 37.9±18.85 years, with 51.2% being males. The outcome was statistically significantly associated with age, marital status, hypertension, disease severity at admission and length of stay at hospital.Conclusion: this study found that age was associated with disease outcome. Care, attention and monitoring should be taken into consideration for hypertensive patients. Patients’ initial signs and symptoms of dyspnea, weakness and sore throat were significantly associated with disease outcome.

Download Full-text

COVID-19 related multisystem inflammatory syndrome in children (MIS-C): a case series from a tertiary care pediatric hospital in Qatar

BMC Pediatrics ◽

10.1186/s12887-021-02743-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mohammad Rubayet Hasan ◽

Khaled Al Zubaidi ◽

Karim Diab ◽

Yahia Hejazi ◽

Sharon Bout-Tabaku ◽

...

Keyword(s):

Clinical Features ◽

Early Recognition ◽

Tertiary Care ◽

Case Series ◽

Case Definition ◽

Cardiac Biomarkers ◽

Medical Attention ◽

Laboratory Findings ◽

First Case ◽

Inflammatory Syndrome

Abstract Background Multisystem Inflammatory Syndrome in Children (MIS-C) is a severe complication of coronavirus disease 2019 (COVID-19) in children, which is increasingly being reported worldwide. Here we report the first case series of 7 children diagnosed with MIS-C in Qatar. Methods Clinical features and outcomes of COVID-19 positive patients admitted to Sidra Medicine, Qatar from June to October 2020, who met the WHO case definition for MIS-C were reviewed. Results The mean age in our case series was 5.6 years, of which 71.4% were males. All patients were previously healthy but had a history of COVID-19 infection. Fever, rash, vomiting and abdominal pain were the most common symptoms (70–100%). The average hospitalization was 12.9 days with no case fatalities. Laboratory findings included lymphopenia and thrombocytopenia in most patients, as well as evidence of coagulopathy and elevated inflammatory markers such as C-reactive protein, ferritin and procalcitonin. Many patients (71.4%) required inotropic support in intensive care, while only one required respiratory support. Although all patients had elevated cardiac biomarkers, cardiovascular involvement was observed in 42.9% of patients with one patient developing a giant coronary aneurysm. All patients received intravenous immunoglobulin (IVIG) and 86% of patients received corticosteroids, with two patients requiring treatment with IL-1 inhibitors. Conclusions Our report is one of the first reports on MIS-C from Asia. Although clinical features and outcomes are not significantly different from those reported elsewhere, lack of case fatalities in our cohort may indicate that early recognition and prompt medical attention is necessary for a favorable outcome in MIS-C.

Download Full-text

A Review on Acute Respiratory Syndrome Corona Virus 2 (SARS-Cov-2) & Its Preventive Management

Asian Journal of Pharmaceutical Research and Development ◽

10.22270/ajprd.v8i3.723 ◽

2020 ◽

Vol 8 (3) ◽

pp. 142-151

Author(s):

Vijay Singh

Keyword(s):

Severe Acute Respiratory Syndrome ◽

Virus Disease ◽

Clinical Manifestations ◽

Health Impact ◽

Host Cells ◽

World Health ◽

Future Perspective ◽

Family Welfare ◽

Corona Virus ◽

Health Organization

At the end of 2019 a novel virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing severe acute respiratory syndrome expanded globally from Wuhan, China. In March 2020 the World Health Organization declared the SARS-Cov-2 virus a global pandemic. Severe Acute Respiratory Syndrome Coronavirus 2 can attack lung cells because there are many conserved receptor entries, namely Angiotensin Converting Enzyme-2. The presence of this virus in host cells will initiate various protective responses leading to pneumonia and Acute Respiratory Distress Syndrome. This review aimed to provide an overview related to this Corona Virus Disease 2019 (COVID-19) epidemiology, pathophysiology, diagnosis, management and future perspective. We searched PubMed, Medline, Embase and Scopus databases for Severe Acute Respiratory Syndrome Coronavirus-2, Middle East respiratory syndrome-related coronavirus and Severe Acute Respiratory Syndrome Coronavirus. Full texts were retrieved, analyzed and developed into an easy-to-understand review. Although only when the pandemic ends it will be possible to assess the full health, social and economic impact of this global disaster, this review represents a picture of the current state of the art. In particular, we focus on public health impact, pathophysiology and clinical manifestations, diagnosis, case management, emergency response and preparedness. The Ministry of Health and Family Welfare, Government of India and ICMR (Indian Council of Medical Research) has formulated guidelines, advisories for social distancing protocol, diagnosis, management, do’s and don’ts and other reliable material.

Download Full-text

COVID 19: REALS AND CHALLENGES AGAINST DOCTORS

Conferences of Medical Sciences Dies Natalis Faculty of Medicine Universitas Sriwijaya ◽

10.32539/dies.v2i1.44 ◽

2020 ◽

Vol 2 (1) ◽

pp. 65-87

Author(s):

Zen Ahmad

Keyword(s):

Virus Disease ◽

Clinical Manifestations ◽

World Health ◽

Unknown Etiology ◽

Wuhan City ◽

Traditional Markets ◽

Pneumonia Case ◽

The World ◽

New Type ◽

Health Organization

Corona Virus Disease (Covid-19) is a contagious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) which was discovered in December 2019 in China. This disease can cause clinical manifestations in the airway, lung and systemic. The World Health Organization (WHO) representative of China reported a pneumonia case with unknown etiology in Wuhan City, Hubei Province, China on December 31, 2019. The cause was identified as a new type of coronavirus on January 7, 2020 with an estimated source of the virus from traditional markets (seafood market). ) Wuhan city

Download Full-text

Ocular and Systemic Manifestations in Paediatric Multisystem Inflammatory Syndrome Associated with COVID-19

Journal of Clinical Medicine ◽

10.3390/jcm10132953 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2953

Author(s):

Tzu-Chen Lo ◽

Yu-Yen Chen

Keyword(s):

Serum Antibody ◽

Case Series ◽

Pooled Analysis ◽

Rt Pcr ◽

Laboratory Findings ◽

Systemic Manifestations ◽

Polymerase Chain ◽

Exposure History ◽

Systemic Symptoms ◽

Inflammatory Syndrome

This study aimed to achieve a better understanding of the epidemiological and clinical characteristics of multisystem inflammatory syndrome in children (MIS-C) following coronavirus disease 2019 (COVID-19). We searched PubMed and Embase between December 2019 and March 2021 and included only peer-reviewed clinical studies or case series. The proportions of patients who had conjunctivitis, systemic symptoms/signs (s/s), Kawasaki disease (KD), and exposure history to suspected/confirmed COVID-19 cases were obtained. Moreover, positive rates of the nasopharyngeal real-time reverse transcriptase polymerase chain reaction (RT-PCR) and serum antibody for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were recorded. Overall, 32 studies with 1458 patients were included in the pooled analysis. Around half of the patients had conjunctivitis. The five most common systemic manifestations were fever (96.4%), gastrointestinal s/s (76.7%), shock (61.5%), rash (57.1%), and neurological s/s (36.8%). Almost one-third presented complete KD and about half had exposure history to COVID-19 cases. The positivity of the serology (82.2%) was higher than that of the nasopharyngeal RT-PCR (37.0%). MIS-C associated with COVID-19 leads to several features similar to KD. Epidemiological and laboratory findings suggest that post-infective immune dysregulation may play a predominant role. Further studies are crucial to elucidate the underlying pathogenesis.

Download Full-text

CASE SERIES: A SPECTRUM OF FUNGAL INFECTIONS IN COVID-19

10.36106/ijsr/8120981 ◽

2021 ◽

pp. 29-30

Author(s):

Venkatesh B. C. ◽

Rajendra Rao K. M. ◽

K. N. Mohan Rao

Keyword(s):

Diabetes Mellitus ◽

Fungal Infections ◽

Virus Disease ◽

Case Series ◽

Health Crisis ◽

Major Health ◽

Corona Virus ◽

Patients With Diabetes ◽

Causative Agents

Corona virus Disease 2019 (COVID-19) pandemic is causing a major health crisis across the globe. With the increasing number of fungal infections associated with COVID-19 being reported, it is imperative to understand the spectrum of such infections. Most documented cases have been reported in patients with diabetes mellitus or treatment with immunomodulators. The most common causative agents are Aspergillus, Candida or Mucorales. This series aims to portray the spectrum of fungal infections associated with COVID-19.

Download Full-text

Chloroquine-induced Prolonged QT Interval in COVID-19 Patients in Indonesia: Case Series

Biomedical & Pharmacology Journal ◽

10.13005/bpj/2094 ◽

2021 ◽

Vol 14 (1) ◽

pp. 01-05

Author(s):

Putu Dyah Widyaningsih ◽

Putu Gita Pranata Putra ◽

DG Wedha Asmara ◽

Erna Bagiari ◽

Agus Santosa ◽

...

Keyword(s):

Qt Interval ◽

Virus Disease ◽

Case Series ◽

Corona Virus ◽

Prolonged Qt Interval ◽

Prolonged Qt ◽

Anti Inflammation

The treatment of corona virus disease 2019 (COVID-19)remains in debate, and the use of chloroquine has not been validated by accurate clinical trials.The aim of this study was to provide the possible cardiotoxicity effect of chloroquine in patients with COVID-19. This study was a case-series of prolonged QT interval of COVID-19 patients treated with chloroquine in a hospital in Bali, Indonesia. There were two cases of COVID-19 with exhibited a prolonged QT interval after being administrated of chloroquine. The prolonged QT interval returned to normal after chloroquine was stopped.These cases alert us the cardiotoxicity effect of chloroquine and the need for serial electro-cardiography monitoring before and during therapy. In conclusion, although antiviral and anti-inflammation properties of chloroquine on COVID-19 are promising, its cardiotoxicity effects should be monitored closely for less harm to the patients.

Download Full-text