1. Multisystem Inflammatory Syndrome in Adults: Case Finding Through Systematic Review of Electronic Medical Records.
- Author
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Melgar, Michael, Haston, Julia, DeCuir, Jennifer, Cheng, Qi, Arnold, Kathryn E, Meng, Lu, Murphy, David J, Overton, Elizabeth, Hollberg, Julie, Tobin-D'Angelo, Melissa, Patel, Pragna, Campbell, Angela P, Godfred-Cato, Shana, and Belay, Ermias D
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ARTIFICIAL blood circulation , *HOSPICE care , *MULTISYSTEM inflammatory syndrome , *COVID-19 , *NOSOLOGY , *ADRENOCORTICAL hormones , *AGE distribution , *LEFT ventricular dysfunction , *RETROSPECTIVE studies , *ACQUISITION of data , *RACE , *ARTIFICIAL respiration , *SEX distribution , *HOSPITAL mortality , *RISK assessment , *HOSPITAL care , *SYMPTOMS , *MEDICAL records , *CRITICAL care medicine , *LONGITUDINAL method , *DISCHARGE planning - Abstract
Background Multisystem inflammatory syndrome in adults (MIS-A) is a severe condition temporally associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods In this retrospective cohort study, we applied the US Centers for Disease Control and Prevention (CDC) case definition to identify diagnosed and undiagnosed MIS-A cases among adults discharged during April 2020–January 2021 from 4 Atlanta, Georgia hospitals affiliated with a single medical center. Non–MIS-A coronavirus disease 2019 (COVID-19) hospitalizations were identified using International Classification of Diseases, Tenth Revision, Clinical Modification encounter code U07.1. We calculated the ratio of MIS-A to COVID-19 hospitalizations, compared demographic characteristics of the 2 cohorts, and described clinical characteristics of MIS-A patients. Results We identified 11 MIS-A cases, none of which were diagnosed by the treatment team, and 5755 COVID-19 hospitalizations (ratio 1:523). Compared with patients with COVID-19, patients with MIS-A were more likely to be younger than 50 years (72.7% vs 26.1%, P <.01) and to be non-Hispanic Black (81.8% vs 50.0%, P =.04). Ten patients with MIS-A (90.9%) had at least 1 underlying medical condition. Two MIS-A patients (18.2%) had a previous episode of laboratory-confirmed COVID-19, occurring 37 and 55 days prior to admission. All MIS-A patients developed left ventricular systolic dysfunction. None had documented mucocutaneous involvement. All required intensive care, all received systemic corticosteroids, 8 (72.7%) required mechanical ventilation, 2 (18.2%) required mechanical cardiovascular circulatory support, and none received intravenous immunoglobulin. Two (18.2%) died or were discharged to hospice. Conclusions MIS-A is a severe but likely underrecognized complication of SARS-CoV-2 infection. Improved recognition of MIS-A is needed to quantify its burden and identify populations at highest risk. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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