A rare but serious coronavirus-related inflammatory condition in children was also recently identified among adults, per a report released Friday from the Centers for Disease Control and Prevention (CDC).
Multisystem inflammatory syndrome in children (MIS-C) usually involves shock, heart malfunction, stomach pain and hyperinflammation. The CDC drew on reports of 27 adult patients to describe a new, similar condition — multisystem inflammatory syndrome in adults (MIS-A).
“These 27 patients had cardiovascular, gastrointestinal, dermatologic, and neurologic symptoms without severe respiratory illness and concurrently received positive test results for SARS-CoV-2…,” per the report. Fortunately, the vast majority (24 of 27) of MIS-A patients survived, which was said to mirror outcomes seen in MIS-C patients treated in intensive health care settings.
There is still much unknown over MIS-A, with a deal of uncertainty over the timeline from SARS-CoV-2 infection to MIS-A onset, but the report suggests “MIS-A and MIS-C might represent postinfectious processes.” Adults who reported typical COVID-19 symptoms went on to develop MIS-A about two to five weeks later.
Patients with MIS-A may not test positive for COVID-19, given the onset of the syndrome weeks later. The agency emphasized the importance of antibody testing for previous SARS-CoV-2 infection to recognize and treat MIS-A.
Of the 27 MIS-A patients included in the report, 30% of them, along with “45% of 440 children with MIS-C reported to CDC through July 29,” tested negative for current SARS-CoV-2 infection but had positive antibody results.
The criteria used to identify MIS-A include severe illness requiring hospitalization in patients over age 21; current or previous SARS-CoV-2 infection in the past 12 weeks; severe dysfunction of one or more organs other than the lungs; lab evidence of severe inflammation and a lack of severe respiratory illness.
Patients were mostly treated with corticosteroids among other treatments like vasopressors (to raise blood pressure) or blood thinners.
The report also noted that “all but one” of the patients in the report were among racial or ethnic minorities, adding that “MIS-C has also been reported disproportionately in these communities.” However, due to the small sample size, the CDC said more research is needed before making conclusions about the burden of MIS-A in various groups.
“Findings indicate that adult patients of all ages with current or previous SARS-CoV-2 infection can develop a hyperinflammatory syndrome resembling MIS-C,” authors wrote, adding that measures to limit COVID-19 spread may help prevent MIS-A.