SARS CoV-2-related multisystem inflammatory syndrome in adults: An observational case series from tropics

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL
Sameer Gulati, Aniket Jagtap, Y. Porwal, Paras Kathuria, Ankur Chikara
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引用次数: 0

Abstract

Background: Extrapulmonary multisystemic manifestations in children were recognized, early in the pandemic, Multisystem Inflammatory Syndrome in Children (MIS-C). Of late, similar manifestations have been reported in adults (Multisystem Inflammatory Syndrome in adults - MIS-A) in too. As new variants of SARS-CoV 2 emerge and fade away, MIS-A needs to be recognized at the most opportune time. Besides, we hypothesize that MIS-A may also co-exist with other tropical infections to further confuse diagnostic scenario. Methodology: A series of five cases of MIS-A is presented. Their demographic, comorbidities, and clinical data were noted. Besides, the clinical and laboratory parameters of patients with and without tropical infections were compared. Results: Patients presented with diverse heterogenous clinical manifestations. The cardiovascular, hematological, and abdominal systems were most commonly involved along with high inflammatory markers. Three of our patients in the present series had tropical infections along with MIS-A. There was no statistically significant difference between clinical manifestations and laboratory parameters among MIS-A patients with and without tropical infections. All the five patients improved on treatment and were discharged home. Conclusions: A high index of suspicion is required to diagnose MIS-A, especially in tropical areas where background rate of other infections is also high. Moreover, these tropical infections may co-occur along with MIS-A, further confusing the diverse heterogenous clinical presentations. Patients with MIS-A may be critically ill, but outcomes are good if lifesaving immunosuppressive therapy is initiated on time.
成人严重急性呼吸系统综合征冠状病毒2型相关多系统炎症综合征:热带地区的一系列观察病例
背景:在疫情早期,儿童的肺外多系统表现被认为是儿童多系统炎症综合征(MIS-C)。最近,成人也有类似的表现(成人多系统炎症综合征-MIS-A)。随着严重急性呼吸系统综合征冠状病毒2型的新变种出现并逐渐消失,需要在最合适的时候识别MIS-A。此外,我们假设MIS-A也可能与其他热带感染共存,以进一步混淆诊断场景。方法:介绍了一系列五例MIS-A病例。注意他们的人口统计学、合并症和临床数据。此外,还比较了热带感染和非热带感染患者的临床和实验室参数。结果:患者表现出不同的异质性临床表现。心血管系统、血液系统和腹部系统与高炎症标志物一起最常见。在本系列中,我们的三名患者患有热带感染和MIS-A。有和没有热带感染的MIS-A患者的临床表现和实验室参数之间没有统计学上的显著差异。所有五名患者在治疗后均有所好转,出院回家。结论:诊断MIS-A需要高的怀疑指数,特别是在热带地区,那里的其他感染背景率也很高。此外,这些热带感染可能与MIS-A同时发生,进一步混淆了不同的异质性临床表现。MIS-A患者可能病情危重,但如果及时开始挽救生命的免疫抑制治疗,结果是好的。
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来源期刊
Indian Journal of Medical Specialities
Indian Journal of Medical Specialities MEDICINE, GENERAL & INTERNAL-
自引率
16.70%
发文量
51
期刊介绍: The Indian Journal of Medical Specialities is an all-encompassing peer-reviewed quarterly journal. The journal publishes scholarly articles, reviews, case reports and original research papers from medical specialities specially pertaining to clinical patterns and epidemiological profile of diseases. An important highlight is the emphasis on undergraduate and postgraduate medical education including various aspects of scientific paper-writing. The journal gives priority to research originating from the developing world, including from the tropical regions of the world. The journal also publishes special issues on health topics of current interest. The Indian Journal of Medical Specialities is one of the very few quality multispeciality scientific medical journals.
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