COVID-19 Associated Multisystem Inflammatory Syndrome in Adults (MIS-A): How Aware Are We?

ABSTRACT

Introduction: Multisystem inflammatory syndrome-in adults (MIS-A), which occurs as a post-acute syndrome associated with COVID-19, is rarely seen and does not come to mind as in pediatric patients. Therefore, it was aimed to raise awareness that MIS-A, which can occur with different clinical presentations and findings, should be considered in the differential diagnosis with this study. Materials and Methods: Of 4984 patients found positive SARS-COV-2 reverse transcriptase-polymerase chain reaction test (RT-PCR) between March 24, 2020 and June 14, 2021, the files of 370 patients hospitalized within 2-12 weeks after their PCR positivity were investigated retrospectively. Analysis results of six cases meeting the MIS-A criteria defined by the American Center for Disease Control and Prevention were evaluated. The results were analyzed using the SPSS program. Results: Six cases meeting the MIS-A criteria were evaluated. Mean age of the six patients was 44.7 ± 10.2 years. Fever (≥38.0°C) was detected in all patients. Gastrointestinal and cardiovascular systems were the two most commonly involved systems. Two patients had nonpurulent conjunctivitis and mucocutaneous involvement. In laboratory examination, all patients had high inflammatory indicators. Although no patient was diagnosed with MIS-A, it was found that all patients received corticosteroid therapy. Finally, none of the patients were mortal. Conclusion: We think that MIS-A should be included in the differential diagnosis in patients with increased inflammation and coagulation parameters along with multisystemic symptoms. However, we claim that it would be fitting to develop a warning system over hospital automation for cases with appropriate clinical and laboratory data to reduce the possibility of skipping the diagnosis due to the emergence of MIS-A with various clinical and system involvements.