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Epidemiologic and clinical characteristics of multisystem inflammatory syndrome in adults: a rapid review
Nicole Atchessi1, Rojiemiahd Edjoc1, Megan Striha1
1Health Security Infrastructure Branch, Public Health Agency of Canada, Ottawa, ON.
Insights
Multisystem inflammatory disease in adults (MIS-A) is a severe COVID-19 complication. This emerging condition presents with fever, digestive issues, and cardiac involvement, requiring hospitalization and potentially leading to death.
Area of Science:
- Infectious Diseases
- Pediatrics
- Internal Medicine
Background:
- Multisystem inflammatory disease in children (MIS-C) is a known severe presentation of COVID-19.
- Similar inflammatory conditions are now being identified in adult populations.
Purpose of the Study:
- To describe the epidemiologic and clinical characteristics of multisystem inflammatory disease in adults (MIS-A).
- To establish a foundation for understanding this emerging disease in adults.
Main Methods:
- Systematic review of nine published case reports of MIS-A.
- Analysis of case descriptions for common clinical features and outcomes.
Main Results:
- Cases occurred in the post-acute phase of COVID-19.
- Common symptoms include fever, digestive issues, and cardiac involvement.
- All patients required hospitalization, with some needing intensive care; one fatality was reported.
Conclusions:
- MIS-A is a severe, potentially fatal complication of COVID-19 in adults.
- Further research into MIS-A pathogenesis is crucial for improved treatment and prevention of adverse outcomes.
Abstract:
Multisystem inflammatory disease in children (MIS-C) is one of the severe presentations of the coronavirus disease 2019 (COVID-19) that has been described in the literature since the beginning of the pandemic. Although MIS-C refers to children, cases with similar clinical characteristics have been recently described in adults. A description of the epidemiologic and clinical characteristics of multisystem inflammatory disease in adults (MIS-A) is a starting point for better knowledge and understanding of this emerging disease. We identified nine case reports of MIS-A in the literature, five from the United States, two from France and two from the United Kingdom. The case descriptions revealed similarities in clinical features, including occurrence during post-acute disease phase, fever, digestive symptoms, cardiac involvement and elevated inflammatory markers. All the patients were hospitalized, three required admission to the intensive care unit and one died. The most common treatments were intravenous immunoglobulin, prednisolone and aspirin. These findings suggest that MIS-A is a severe complication of COVID-19 disease that can lead to death. Further studies to improve our understanding of the pathogenesis of MIS-A, which will help improve treatment decisions and prevent sequelae or death.
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