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Clinical Characteristics of Multisystem Inflammatory Syndrome in Adults: A Systematic Review

Pragna Patel1, Jennifer DeCuir1,2, Joseph Abrams1

  • 1CDC COVID-19 Response, Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia.

JAMA Network Open
|September 22, 2021
PubMed
Abstract

Insights

Multisystem inflammatory syndrome in adults (MIS-A) is a serious hyperinflammatory condition occurring about 4 weeks after COVID-19. Early diagnosis and treatment are crucial for managing this severe post-COVID-19 complication.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Public Health

Background:

  • Multisystem inflammatory syndrome in adults (MIS-A) is a rare but serious complication following COVID-19.
  • Improved understanding of MIS-A epidemiology and clinical features is essential for timely diagnosis and effective management.
  • MIS-A can lead to significant morbidity and mortality if not promptly addressed.

Purpose of the Study:

  • To systematically review and summarize the descriptive epidemiology of MIS-A.
  • To delineate the clinical characteristics and presentation of MIS-A in adults.
  • To inform clinical practice and public health strategies for MIS-A.

Main Methods:

  • A systematic review of literature from May 2020 to May 2021, encompassing multiple databases (MEDLINE, Embase, etc.).
  • Inclusion of voluntary reports of MIS-A to the CDC and specific age groups from the CDC's MIS in children surveillance.
  • Analysis of data from 221 identified patients with MIS-A.

Main Results:

  • The median age of MIS-A patients was 21 years, with 70% being male. 36% were non-Hispanic Black individuals.
  • Common symptoms included fever (96%), hypotension (60%), cardiac dysfunction (54%), shortness of breath (52%), and diarrhea (52%).
  • Median of 5 organ systems were involved, with 57% requiring ICU admission, 47% needing respiratory support, and a 7% mortality rate. 72% had positive SARS-CoV-2 serology.

Conclusions:

  • MIS-A is a severe hyperinflammatory condition that typically manifests approximately 4 weeks after symptomatic COVID-19.
  • Extrapulmonary multiorgan dysfunction is a hallmark of MIS-A.
  • Findings underscore the need for heightened clinical awareness and prompt intervention for MIS-A.

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