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Fatal SARS-CoV-2 Inflammatory Syndrome and Myocarditis in an Adolescent: A Case Report.
Beaudry, Jeanette T; Dietrick, Barbara; Lammert, Dawn B; Constas, Alexander; McCaw, Julia; Hammond, John; Buendia, Matthew; Stein, Julie E; Pekosz, Andrew; Schuette, Jennifer; Mostafa, Heba H; Hooper, Jody E; Bernier, Meghan; Agwu, Allison; Feldman, Leonard S.
  • Beaudry JT; Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Dietrick B; Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Lammert DB; Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Constas A; Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • McCaw J; Anesthesiology and Critical Care, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Hammond J; Anesthesiology and Critical Care, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Buendia M; Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Stein JE; Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Pekosz A; Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Schuette J; Microbiology and Immunology, Johns Hopkins University School of Public Health, Baltimore, Maryland.
  • Mostafa HH; Anesthesiology and Critical Care, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Hooper JE; Medical Microbiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Bernier M; Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Agwu A; Anesthesiology and Critical Care, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Feldman LS; Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Pediatr Infect Dis J ; 40(2): e72-e76, 2021 02 01.
Article in English | MEDLINE | ID: covidwho-1207336
ABSTRACT

BACKGROUND:

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), an entity in children initially characterized by milder case presentations and better prognoses as compared with adults. Recent reports, however, raise concern for a new hyperinflammatory entity in a subset of pediatric COVID-19 patients.

METHODS:

We report a fatal case of confirmed COVID-19 with hyperinflammatory features concerning for both multi-inflammatory syndrome in children (MIS-C) and primary COVID-19.

RESULTS:

This case highlights the ambiguity in distinguishing between these two entities in a subset of pediatric patients with COVID-19-related disease and the rapid decompensation these patients may experience.

CONCLUSIONS:

Appropriate clinical suspicion is necessary for both acute disease and MIS-C. SARS-CoV-2 serologic tests obtained early in the diagnostic process may help to narrow down the differential but does not distinguish between acute COVID-19 and MIS-C. Better understanding of the hyperinflammatory changes associated with MIS-C and acute COVID-19 in children will help delineate the roles for therapies, particularly if there is a hybrid phenotype occurring in adolescents.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Myocarditis Type of study: Case report / Diagnostic study / Prognostic study Topics: Long Covid Limits: Adolescent / Female / Humans Language: English Journal: Pediatr Infect Dis J Journal subject: Communicable Diseases / Pediatrics Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Myocarditis Type of study: Case report / Diagnostic study / Prognostic study Topics: Long Covid Limits: Adolescent / Female / Humans Language: English Journal: Pediatr Infect Dis J Journal subject: Communicable Diseases / Pediatrics Year: 2021 Document Type: Article