scholarly journals Post- COVID-19 multisystem inflammatory syndrome in children

2021 ◽  
Vol 6 (4) ◽  
pp. 245-248
Author(s):  
Varsha Dalal ◽  
Rincy Anna Reji ◽  
Ruchika Jain ◽  
Sreelakshmi S Mohandas ◽  
Prasad Bali
Keyword(s):  
Cardiogenic Shock ◽  
Treatment Protocol ◽  
Health Condition ◽  
Case Definition ◽  
Worldwide Population ◽  
Severe Acute Respiratory Infection ◽  
Resuscitation Strategy ◽  
Future Direction ◽  
Inflammatory Syndrome ◽  
Death Cases

COVID-19 is a severe acute respiratory infection affecting worldwide population. There are many cases of complications after the COVID exposure occurring nowadays. One among is Post-COVID-19 Multisystem Inflammatory Syndrome in Children (MIS-C). As per CDC report till March 1, 2021, 2617 cases of MIS-C were meeting the definite case criteria and among 33 death cases were reported. Here we report a case of COVID-19 associated Multi-system inflammatory syndrome in a child (MIS-C) interpreted with WHO case definition criteria. The patient was a 7-year-old boy, with initial presentation of moderate fever, non-itchy red blanching rashes, breathlessness, later progressed to cardiogenic shock accompanied by positive SARS-CoV-2 antigen result. The emergency cardiogenic shock treatment protocol was followed with initial stabilization and resuscitation strategy. He was successfully managed by three days of IV Immunoglobulin 2g/kgand Methylprednisolone 2mg/kg/day therapy along with other supportive treatments. The patient was discharged after 20 days of hospital stay with improved health condition. Our case report will strengthen the exposure-outcome relations between the coronavirus infection and MIS-C, moreover the strategies carried out in our case will be a future direction for the effective management of MIS-C.

scholarly journals Risk stratification in cardiogenic shock: a focus on the available evidence

2021 ◽  
Author(s):  
C. Sciaccaluga ◽  
G. E. Mandoli ◽  
N. Ghionzoli ◽  
F. Anselmi ◽  
C. Sorini Dini ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Cardiogenic Shock ◽  
Clinical Syndrome ◽  
Diagnostic Assessment ◽  
Prognostic Scores ◽  
Current Evidence ◽  
Efficient Resource ◽  
Threatening Condition ◽  
Life Threatening ◽  
Future Direction

AbstractCardiogenic shock is a clinical syndrome which is defined as the presence of primary cardiac disorder that results in hypotension together with signs of organ hypoperfusion in the state of normovolaemia or hypervolaemia. It represents a complex life-threatening condition, characterized by a high mortality rate, that requires urgent diagnostic assessment as well as treatment; therefore, it is of paramount important to advocate for a thorough risk stratification. In fact, the early identification of patients that could benefit the most from more aggressive and invasive approaches could facilitate a more efficient resource allocation. This review attempts to critically analyse the current evidence on prognosis in cardiogenic shock, focusing in particular on clinical, laboratoristic and echocardiographic prognostic parameters. Furthermore, it focuses also on the available prognostic scores, highlighting the strengths and the possible pitfalls. Finally, it provides insights into future direction that could be followed in order to ameliorate risk stratification in this delicate subset of patients.

Clinical case definition and manifestations of paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome

AIDS ◽  
2009 ◽  
Vol 23 (18) ◽  
pp. 2467-2471 ◽  
Author(s):  
Weerawat Manosuthi ◽  
Hong Van Tieu ◽  
Wiroj Mankatitham ◽  
Aroon Lueangniyomkul ◽  
Jintanat Ananworanich ◽  
...  
Keyword(s):  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Clinical Case ◽  
Case Definition ◽  
Inflammatory Syndrome ◽  
Clinical Case Definition

scholarly journals Epidemiology of Severe Acute Respiratory Infection (SARI) Cases at a sentinel site in Egypt, 2013–15

2019 ◽  
Vol 42 (3) ◽  
pp. 525-533 ◽  
Author(s):  
Mohamed M Elhakim ◽  
Sahar K Kandil ◽  
Khaled M Abd Elaziz ◽  
Wagida A Anwar
Keyword(s):  
Respiratory Infection ◽  
Acute Respiratory Infection ◽  
Influenza A ◽  
Case Definition ◽  
Quality Data ◽  
Influenza B ◽  
Sentinel Site ◽  
Influenza A Viruses ◽  
High Quality Data ◽  
Severe Acute Respiratory Infection

Abstract Background Sentinel surveillance for severe acute respiratory infection (SARI) in Egypt began in 2006 and occurs at eight sites. Avian influenza is endemic, and human cases of influenza A (H5N1) have been reported annually since 2006. This study aimed to describe the epidemiology of SARI at a major sentinel site in the country. Methods Data included in the study were collected from a major SARI sentinel site in Egypt during three consecutive years (2013–15). Results A total of 1254 SARI patients conforming to the WHO case definition were admitted to the sentinel site, representing 5.6% of admitted patients for all causes and 36.6% of acute respiratory infection patients. A total of 99.7% of the patients were tested, and 21.04% tested positive; 48.7% of cases involved influenza A viruses, while 25% involved influenza B. The predominant age group was under 5 years of age, accounting for 443 cases. The seasonality of the influenza data conformed to the Northern Hemisphere pattern. Conclusions The present study’s results show that SARI leads to substantial morbidity in Egypt. There is a great need for high-quality data from the SARI surveillance system in Egypt, especially with endemic respiratory threats such as influenza A (H5N1) in Egypt.

scholarly journals MIS-C Treatment: Is IVIG Always Necessary?

2021 ◽  
Vol 9 ◽  
Author(s):  
Francesco Licciardi ◽  
Letizia Baldini ◽  
Marta Dellepiane ◽  
Carlotta Covizzi ◽  
Roberta Mogni ◽  
...  
Keyword(s):  
Coronary Artery Aneurysm ◽  
Fluid Management ◽  
Treatment Protocol ◽  
Artery Aneurysm ◽  
High Dose ◽  
Dose Increase ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Inflammatory Syndrome

Background: MIS-C is a potentially severe inflammatory syndrome associated with SARS-CoV-2 exposure. Intravenous immunoglobulin (IVIG) is considered the first-tier therapy, but it implies infusion of large fluid volumes that may worsen cardiac function.Patients and Methods: Since April 2020, we have developed a treatment protocol that avoids the infusion of IVIG as first-line therapy in the early phase of MIS-C. In this study, we retrospectively analyzed a cohort of consecutive patients treated according to this protocol between 01/04/2020 and 01/04/2021.Results: In the last year, 31 patients have been treated according to the protocol: 25 with high-dose pulse MP (10 mg/kg) and 6 with 2 mg/kg. 67.7% of the patients responded to the initial treatment, while the others needed a step-up, either with Anakinra (25.8%) or with MP dose increase (6.5%). IVIG was administered in four patients. Overall, only one patient (3.2%) needed ICU admission and inotropic support; one patient developed a small coronary artery aneurysm.Conclusions: Timely start of MP therapy and careful fluid management might improve the outcomes of MIS-C patients.

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

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.

scholarly journals Two cases of multi-inflammatory syndrome in children (MIS-C) in adults in 2020

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zachary Ciochetto ◽  
Peter L. Havens ◽  
Sol Aldrete
Keyword(s):  
Coronary Artery ◽  
Old French ◽  
Standard Of Care ◽  
Late Complications ◽  
Case Definition ◽  
White Female ◽  
High Dose ◽  
Current Case ◽  
Reduced Ejection Fraction ◽  
Inflammatory Syndrome

Abstract Background Late complications and longer-lasting sequelae of COVID-19 infection in adults can occur. Cardiovascular involvement including reduced ejection fraction, coronary artery aneurysms, and pericardial involvement have been reported. Prompt recognition is the first step and secondly, these cardiovascular phenomena require an alternative set of therapeutics from the standard of care for acute COVID-19 infection. Case presentation Here we describe two cases that fulfill the current case definition of the recently defined multisystem inflammatory syndrome in adults (MIS-A). One patient is a 27-year-old white female and the other a 21-year-old French creole male, both without any prior medical history. Both were hospitalized and found to have significant cardiac dysfunction and treated with IVIG, high dose aspirin, and corticosteroids with resolution of their acute illnesses and cardiac sequelae. Conclusion Not only does the immediate impact of this viral infection need to be addressed, but also the long-term complications that could arise if not recognized and treated promptly as seen in our two cases. Patients can develop acute cardiovascular collapse and cardiogenic shock which requires high level of care and treatment within an intensive care unit. Depending on the complications, patients may require treatment for congestive heart failure, pericarditis, or even coronary artery disease acutely with close follow up to ensure improvement or resolution.

scholarly journals Women’s Resilience and Vulnerability in Facing COVID-19 in DKI Jakarta and East Java

Populasi ◽  
2021 ◽  
Vol 28 (2) ◽  
pp. 96
Author(s):  
Ashilly Achidsti ◽  
Oktafia Kusuma Sari ◽  
Desy Putri Ratnasari ◽  
Nourmalita Safitri Ningsih ◽  
Aulia Reski Widyaningrum ◽  
...  
Keyword(s):  
Immune Responses ◽  
Public Transportation ◽  
Health Workers ◽  
Task Force ◽  
Medical Condition ◽  
Health Condition ◽  
Religious Activities ◽  
Literature Reviews ◽  
Death Cases ◽  
Ace2 Gene

Indonesia ranks 23rd as the most COVID-19 confirmed cases in the world. DKI Jakarta and East Java provinces have the highest cases in Indonesia. However, data on the transmission of COVID-19 in both provinces were not further analyzed regarding vulnerability between genders. This research attempted to compare the differences in the gender distribution of COVID-19 cases by analyzing data from COVID-19 DKI Jakarta and East Java Task Force Information Center and various biological, medical, and socio-cultural studies to understand risk of women being exposed to COVID-19. The results of this research revealed that both provinces had a higher number of confirmed patients under surveillance (PDP), people under surveillance (ODP), and death cases in men than that of women. In DKI Jakarta, the number of recovered cases in men was higher than that of women, but in East Java it was not significantly different. Based on literature reviews, women were more resilience in manifestations of COVID-19 severity than that of men due to differences in ACE2 gene distribution and expression, hormones regulations, immune responses, comorbidities, and ages. However, data from socio-cultural literature reviews in both provinces showed women were vulnerable to be exposed to COVID-19 since many women performed as health workers, office workers, market traders, public transportation users, and did religious activities. Besides, women were vulnerable due to mental health condition, such as depression, anxiety, and special medical condition (e.g. being exposed to or infected with COVID-19 during pregnancy).

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