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

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.

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

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.

scholarly journals Multisystem inflammatory syndrome in children - a clinical example in pediatrics

2021 ◽  
Vol 25 (2) ◽  
pp. 258-260
Author(s):  
V. M. Dudnyk ◽  
V. Н. Furman ◽  
I. I. Andrikevych ◽  
N. O. Buglova ◽  
O. V. Кutsak ◽  
...  
Keyword(s):  
Serological Test ◽  
World Health ◽  
Rt Pcr ◽  
The Us ◽  
Control And Prevention ◽  
Coronavirus Infection ◽  
Polymerase Chain ◽  
Health Organization ◽  
Inflammatory Syndrome

Annotation. Peculiarities of clinical course and differential diagnosis of multisystem inflammatory syndrome (MIS-C) in children with coronavirus infection are described. The main features of this disease are long-term fever, multiorgan dysfunction, laboratory signs of inflammation and positive tests for SARS-CoV-2 (polymerase chain reaction using reverse transcription (RT-PCR), antigen test or positive serological test). The criteria of the World Health Organization (WHO) and the US Centers for Disease Control and Prevention (CDC) are used to confirm the MIS-C diagnosis.

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 Case Report: Acute Intracardiac Thrombosis in Children With Coronavirus Disease 2019 (COVID-19)

2021 ◽  
Vol 9 ◽  
Author(s):  
Hamid Bigdelian ◽  
Mohsen Sedighi ◽  
Mohammad Reza Sabri ◽  
Bahar Dehghan ◽  
Chehreh Mahdavi ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Cardiac Surgery ◽  
Case Report ◽  
Case Series ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Inflammatory State ◽  
Polymerase Chain ◽  
Underlying Mechanisms ◽  
Intracardiac Thrombosis

We herein describe a case series of children with SARS-CoV-2 infection (COVID-19) complicated with acute intracardiac thrombosis. The diagnosis of COVID-19 was confirmed through the reverse transcription-polymerase chain reaction (RT-PCR). Transthoracic echocardiography of patients revealed large intracardiac mobile masses resected successfully via cardiac surgery. The underlying mechanisms of this thrombus in the COVID-19 infection may be attributed to the hypercoagulation and inflammatory state of the disease incurred by the SARS-CoV-2 virus.

scholarly journals Multisystem inflammatory syndrome associated with SARS-CoV-2 infection in 45 children: a first report from Iran

2020 ◽  
Vol 148 ◽  
Author(s):  
Setareh Mamishi ◽  
Zahra Movahedi ◽  
Mohsen Mohammadi ◽  
Vahid Ziaee ◽  
Mahmoud Khodabandeh ◽  
...  
Keyword(s):  
Wide Spectrum ◽  
Case Series ◽  
Signs And Symptoms ◽  
Case Definition ◽  
Laboratory Findings ◽  
Duration Of Symptoms ◽  
Presenting Symptoms ◽  
Hands And Feet ◽  
Inflammatory Syndrome ◽  
D Dimer

Abstract During the coronavirus disease 2019 (COVID-19) pandemic, a new phenomenon manifesting as a multisystem inflammatory syndrome in children (MIS-C) which has a similar clinical presentation to Kawasaki disease, toxic shock syndrome and severe sepsis has emerged. Although the number of MIS-C reports is increasing, rare reports in Asia is still available. To our knowledge, this study is the largest series of published MIS-C cases in Iran. We performed a retrospective study of all patients with case definition for MIS-C admitted to the three paediatric hospitals in Iran. All of these hospitals are located within the most active COVID-19 pandemic areas (Tehran, Qom and Mazandaran) in Iran. Demographic characteristics, clinical data, laboratory findings, imaging and echocardiographic findings, treatment and outcomes were collected. Between 7 March and 23 June 2020, 45 children were included in the study. The median age of children was 7 years (range between 10 months and 17 years). Common presenting symptoms include fever (91%), abdominal pain (58%), nausea/vomiting (51%), mucocutaneous rash (53%), conjunctivitis (51%) and hands and feet oedema (40%) with median duration of symptoms prior to presentation of 5 (interquartile range (IQR) 3, 7) days. Fifty-three percent of children showed lymphopaenia. Overall, the majority of cases at admission had markedly elevated inflammatory markers erythrocyte sedimentation rate (ESR) (95.5%) and C-reactive protein (CRP) (97%). Ferritin was abnormal in 11 out of 14 tested patients (73%), and it was highly elevated (>500 ng/ml) in 47% of cases. Median fibrinogen level was 210 (IQR 165, 291) mg/dl, D-dimer was 3909 (IQR 848, 4528) ng/ml and troponin was 0.6 (IQR 0.1, 26) ng/ml, respectively. Twenty out of 31 patients (64.5%) had hypoalbuminaemia. In addition, hyponatraemia was found in 64% of cases. Twenty-five patients (56%) presented with cardiac involvement and acute renal failure was observed in 13 cases (29%). Pleural, ascitic, ileitis and pericardial effusions were found in 18%, 11%, 4% and 2% of cases, respectively. In conclusion, this is a first large case series of hospitalised children who met criteria for MIS-C in Iran. There was a wide spectrum of presenting signs and symptoms; evidence of inflammation with abnormal values of CRP, ESR, D-dimer, ferritin and albumin; and multi-organ involvement.

Multisystem Inflammatory Syndrome in Infant with Negative SARS-CoV-2 RT-PCR and Antibodies

2021 ◽  
pp. 35-39
Author(s):  
Hanna Sahhar ◽  
Karly Derwitz ◽  
Erica Rubin
Keyword(s):  
Polymerase Chain Reaction ◽  
Severe Acute Respiratory Syndrome ◽  
Early Diagnosis ◽  
World Health ◽  
Rt Pcr ◽  
Chain Reaction ◽  
The World ◽  
Polymerase Chain ◽  
Health Organization ◽  
Inflammatory Syndrome

Since the declaration of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in March 2020 by the World Health Organization (WHO), there has been an emergence of a new syndrome termed multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19. MIS-C is defined by the presence of fever, systemic inflammation and multiorgan dysfunction in association with SARS-CoV-2 infection or COVID-19 exposure. Knowledge of this syndrome’s presentation and pathophysiology is constantly evolving as more cases are reported in the literature. This case identifies a 3-month-old patient who tested negative for SARS-CoV-2 antigen, reverse transcriptase polymerase chain reaction (RT-PCR) and antibodies but qualified for MIS-C diagnosis. To the best of our knowledge and through extensive research at the time of diagnosing and reporting this condition to the healthcare authorities, we report the youngest pediatric patient with MIS-C diagnosis. We document this case to contribute to further understanding the variable manifestations of MIS-C and the importance of early diagnosis and treatment with intravenous immunoglobulin (IVIG).

scholarly journals First Detection and Characterization of Chrysanthemum virus B infecting Chrysanthemum in Thailand

2021 ◽  
Author(s):  
Salit Supakitthanakorn ◽  
Garnjana Wichitrakoonthavorn ◽  
Kaewalin Kunasakdakul ◽  
On-Uma Ruangwong
Keyword(s):  
Cultural Values ◽  
Ornamental Plants ◽  
Systemic Symptom ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Transmission Electron ◽  
Staining Methods ◽  
Polymerase Chain ◽  
Systemic Symptoms

Abstract Chrysanthemum is one of the important ornamental plants in worldwide due to its high economic and cultural values. Chrysanthemum leaves showed mosaic, ringspot, yellowing and mild mottle symptoms were observed and collected from cultivation areas in northern Thailand and used for detection of important viruses infecting chrysanthemum. Chrysanthemum virus B (CVB) was detected by reverse transcription polymerase chain reaction (RT-PCR) from samples showing yellowing and mild mottle symptoms. Sequences of the coat protein (CP) gene of two CVB isolates found in this study were sequenced and shared 93.15% homology with other CVB isolates from different countries deposited in GenBank. Biological indexing of these CVB found that they induced both local and systemic symptoms in tobacco plants while petunia displayed a systemic symptom. The particles of CVB were observed under transmission electron microscope (TEM), prepared by dip preparation and negative staining methods, showing slightly flexuous rod-shaped virions approximately 600–650 nm in length. To our knowledge, this is the first detection and study on molecular and biological characteristics of CVB infecting chrysanthemum in Thailand.

scholarly journals Characteristics and outcomes of clinically diagnosed RT-PCR swab negative COVID-19: a retrospective cohort study

2020 ◽  
Author(s):  
Paul Middleton ◽  
Pablo N. Perez-Guzman ◽  
Alexandra Cheng ◽  
Naveenta Kumar ◽  
Mara D. Kont ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clinical Features ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Length Of Hospital Stay ◽  
Discharge Summary ◽  
Rt Pcr ◽  
Laboratory Findings ◽  
Scale Characteristics ◽  
Polymerase Chain

AbstractPatients with strong clinical features of COVID-19 with negative real time polymerase chain reaction (RT-PCR) SARS-CoV-2 testing are not currently included in official statistics. The scale, characteristics and clinical relevance of this group are thus unknown. We performed a retrospective cohort study in two large London hospitals to characterize the demographic, clinical, and hospitalization outcome characteristics of swab-negative clinical COVID-19 patients. We found 1 in 5 patients with a negative swab and clinical suspicion of COVID-19 received a clinical diagnosis of COVID-19 within clinical documentation, discharge summary or death certificate. We compared this group to a similar swab positive cohort and found similar demographic composition, symptomology and laboratory findings. Swab-negative clinical COVID-19 patients had better outcomes, with shorter length of hospital stay, reduced need for >60% supplementary oxygen and reduced mortality. Patients with strong clinical features of COVID-19 that are swab-negative are a common clinical challenge. Health systems must recognize and plan for the management of swab-negative patients in their COVID-19 clinical management, infection control policies and epidemiological assessments.

scholarly journals Assessment of Coronavirus in the Conjunctival Tears in Pediatric Patients with Asymptomatic COVID-19 Infection in Sohag Government, Egypt

2021 ◽  
Vol 15 (1) ◽  
pp. 83-88
Author(s):  
Hany Mahmoud ◽  
Ahmed Radwan ◽  
Amr El Rashidy ◽  
Hesham M. Hefny ◽  
Amal H. Ali ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Pediatric Patients ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Interventional Study ◽  
Chain Reaction ◽  
Intimate Contact ◽  
Asymptomatic Patients ◽  
Systemic Manifestations ◽  
Polymerase Chain

Objective: The present study aims to evaluate coronavirus shedding in the tears of asymptomatic pediatric COVID-19 positive patients. Methods: A prospective interventional study that included a total of 145 pediatric asymptomatic COVID-19 patients hospitalized from 17th May 2020 to 16th July 2020 in Sohag Tropical Hospital. On admission, all of them were COVID-19 positive detected through nasopharyngeal swab. They were in intimate contact with positive symptomatic COVID-19 patients before testing and admission. Reverse Transcriptase Polymerase chain reaction (RT-PCR) was done for tears samples at an interval of 5 days after admission and twice before discharge. Results: Of the 145 asymptomatic pediatric COVID-19 positive patients, no one showed ocular or systemic manifestations. They were silent carriers. Ten were positive for tears sample on admission. They became negative for nasopharyngeal and tear samples before discharge. Conclusion: Pediatric positive COVID-19 patients can shed coronavirus through their tears. Even among asymptomatic patients, transmission through tears is possible.

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