Multisystem Inflammatory Syndrome of Adults (MIS-A) as Delayed Severe Presentation of SARS-CoV-2 Infection: A Description of Two Cases

• Published in: Journal of clinical medicine 2024-11, Vol.13 (22), p.6632
• Main Authors: Raffeiner, Bernd, Rojatti, Marco, Tröbinger, Christian, Nailescu, Adriana Manuela, Pagani, Leonardo
• Format: Article
• Language: English
• Subjects: Adults; Antibodies; Biopsy; Blood tests; Cardiac arrhythmia; Case Report; COVID-19; Cytokine storm; Edema; Heart; Hypotension; Immunoglobulins; Immunology; Infection; Infections; Inflammation; Liver; Medical imaging; Mortality; Pandemics; Patients; Serology; Severe acute respiratory syndrome coronavirus 2; Skin; Thrombocytopenia
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm13226632

SARS-CoV-2 infection can lead to a potentially life-threatening condition known as SARS-CoV-2-associated multisystem inflammatory syndrome in children (MIS-C), which differs from the severe lung disease and thrombotic complications commonly seen in adults. Recently, similar cases have been identified in adults, characterized by a clinical multisystem inflammatory syndrome referred to as MIS-A, which can emerge as a late and severe complication of SARS-CoV-2 infection. We report two cases of MIS-A that were recently admitted to our hospital. Both patients developed a severe multisystem inflammatory syndrome despite experiencing only mild SARS-CoV-2 infection. Key clinical features in both cases included significant systemic inflammation, prominent cardiac involvement, and thrombocytopenia. Prior SARS-CoV-2 infection was confirmed through serological testing. Treatment protocols for MIS-C, including steroids and immunoglobulins, proved effective for both patients. Clinicians should remain vigilant for MIS-A in the context of ongoing SARS-CoV-2 infection worldwide. This infection, even when presenting with mild or no symptoms, can progress to a life-threatening hyperinflammatory syndrome with cardiac implications if not promptly recognized and treated.