Related Experiment Video
Updated: Jul 25, 2025
Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
Published on: June 16, 2020
Multiorgan Inflammatory Syndrome in Adults MIS-A Post SARS-CoV-2 Infection: A Novel Clinical Enigma
Ashwin Gawas1, Ramnath P Nevrekar2, Anar V Khandeparkar3
1Registrar, Department of Nephrology.
Background:
Multisystem inflammatory syndrome in adults (MIS-A) is an emergent heterogenous clinical syndrome seen in the convalescent phase of COVID-19 infection. MIS in children (MIS-C) is a rare but severe post-COVID-19 illness that has been recognized by the WHO and the Centre for Disease Control and Prevention (CDC). It introduced a similar illness in adults based on multiple case series, identified as MIS-A.
Objective:
We present four rare cases of multiorgan inflammatory syndrome in adults (MI-A) presented in Goa Medical College (Tertiary Medical Institute). We would like to highlight the diversity of presentation of symptoms with a significant history of previous covid infection, laboratory abnormalities, the clinical course of the disease, treatment strategies, and response and follow-up findings. We seek to highlight the emergence of a serious clinical entity that can be fatal if not diagnosed or treated promptly.
Materials And Methods:
This was a descriptive study conducted in Goa Medical College from June 2021 to November 2021. A systematic search in the Department of General Medicine, the Department of Medical Records, and data from ICU, ITU, and critical covid wards were collected.
Results And Conclusion:
A total of four cases fulfilling the criteria for MIS-A as per MMWR (CDC 2020)were included, ranging from the age group of 29-70 years. All had features of severe systemic inflammatory response with multiple organ dysfunction and elevated proinflammatory markers. All four patients had a recent history of (mild) COVID-19 infection. Hence, in the current pandemic scenario, MIS-A should be considered as a possible diagnosis in patients with recent COVID infection presenting with MODS, when the obvious septic cause is excluded through thorough clinical, physical, serological, laboratory, and radiological investigations. However, the presence of a past covid infection may not be an absolute criterion due to mild symptoms of the primary covid infection which usually go unnoticed resulting in nontesting.
Insights
Multisystem inflammatory syndrome in adults (MIS-A) is a severe post-COVID-19 condition. Prompt diagnosis and treatment are crucial for patients presenting with multi-organ dysfunction after COVID-19 infection.
Area of Science:
- Critical care medicine
- Infectious diseases
- Rheumatology
Background:
- Multisystem inflammatory syndrome in adults (MIS-A) is an emergent syndrome in the convalescent phase of COVID-19.
- MIS-A shares similarities with MIS in children (MIS-C), a recognized severe post-COVID-19 illness.
- This study highlights MIS-A as a serious clinical entity with potentially fatal outcomes if not promptly diagnosed and treated.
Observation:
- Four rare cases of MIS-A presented at Goa Medical College between June and November 2021.
- Patients ranged from 29-70 years old, all with a history of recent (mild) COVID-19 infection.
- Cases exhibited diverse symptoms, laboratory abnormalities, and severe systemic inflammatory response with multiple organ dysfunction.
Findings:
- All four MIS-A cases met CDC 2020 criteria, presenting with elevated proinflammatory markers.
- Patients displayed multi-organ dysfunction, indicating a severe systemic inflammatory response.
- A history of COVID-19 infection was noted in all cases, though primary infection symptoms were often mild and unnoticed.
Implications:
- MIS-A should be considered in patients with recent COVID-19 presenting with multi-organ dysfunction, after excluding sepsis.
- Early recognition and management are vital to prevent fatal outcomes associated with MIS-A.
- The study underscores the importance of considering MIS-A even when prior COVID-19 infection was asymptomatic or mild.
More Related Videos
Related Concept Videos
01:25Endocarditis II: Clinical Features of Infective Endocarditis
01:27Myocarditis II: Clinical Features and Diagnostic Tests
01:14Myocarditis III: Medical Management
01:28Inflammatory Response
Inflammation can be triggered by various stimuli, such as impact, abrasion, chemical irritation, infections, and extreme hot or cold temperatures. These can damage cells and connective tissue fibers,...
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:24Nephrotic Syndrome I : Introduction