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Fatal SARS-CoV-2 Inflammatory Syndrome and Myocarditis in an Adolescent: A Case Report
Jeanette T Beaudry1,2, Barbara Dietrick1, Dawn B Lammert1
1Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.
The Pediatric Infectious Disease Journal
|November 12, 2020
Summary
A fatal case of pediatric COVID-19 presented with hyperinflammatory features, blurring lines between multi-inflammatory syndrome in children (MIS-C) and primary infection. Early diagnosis and understanding these severe presentations are critical for effective treatment.
Area of Science:
- Pediatric Infectious Diseases
- Critical Care Medicine
- Immunology
Background:
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19).
- Pediatric COVID-19 cases typically present with milder symptoms than adults.
- Emerging reports indicate a hyperinflammatory syndrome in a subset of pediatric patients.
Observation:
- A fatal case of confirmed COVID-19 in a child exhibited hyperinflammatory features.
- The clinical presentation was concerning for both multi-inflammatory syndrome in children (MIS-C) and primary COVID-19.
- Distinguishing between MIS-C and primary COVID-19 in pediatric patients can be challenging.
Findings:
- Rapid decompensation occurred in the reported pediatric case.
- SARS-CoV-2 serologic tests may aid early diagnosis but do not differentiate between acute COVID-19 and MIS-C.
- Hyperinflammatory changes in pediatric COVID-19 and MIS-C require further understanding.
Implications:
- Clinical suspicion for both acute COVID-19 and MIS-C is essential in pediatric patients.
- Further research into hyperinflammatory syndromes in children is needed to guide therapeutic strategies.
- Understanding hybrid phenotypes may inform treatment for adolescents with severe COVID-19 related illness.
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