COVID-19-Related Multisystem Inflammatory Syndrome in Adults

Rarely, adults who have recovered from COVID-19 can develop multisystem inflammatory syndrome, and clinicians should consider this possibility in adults with specific symptoms, as described by doctors in a case study published in CMAJ (Canadian Medical Association Journal).

A 60-year-old man, who had tested positive for SARS-CoV-2 four weeks earlier, visited the hospital for a range of symptoms, including prolonged shortness of breath, high fever, swelling and severe fatigue. Tests found enlarged heart and lung swelling and other problems.

“Given the patient’s recent history of SARS-CoV-2 infection, fever without localization of symptoms, oral mucosal changes, cervical lymphadenopathy, conjunctivitis, and lower extremity changes, we suspected an inflammatory post-COVID-19 syndrome . The presentation was similar to reported cases of an uncommon but serious complication in children and adolescents infected with SARS-CoV-2, the childhood multisystem inflammatory syndrome (MIS-C), as well as Kawasaki-like disease,” write Drs. . Genevieve Kerkerian and Stephen Vaughan, infectious disease specialists, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta.

Rapid start of medication helped the patient to recover.

Previous cases of the syndrome in adults have been documented in people under the age of 50. The authors suggest that age should not limit the possible diagnosis.

Much is unknown about multisystem inflammatory syndrome in adults (MIS-A).

“Unlike MIS-C, there is currently no obligation to report cases of MIS-A to provincial or state authorities, but this should be encouraged to facilitate research and improve patient outcomes,” the authors conclude.

Reference: June 21, 2021, CMAJ (Canadian Medical Association Journal).
DOI: 10.1503/cmaj.210232