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Multisystem Inflammatory Syndrome in Adults: Case Finding Through Systematic Review of Electronic Medical Records.
- Source :
- Clinical Infectious Diseases; Dec2022, Vol. 75 Issue 11, p1903-1911, 9p
- Publication Year :
- 2022
-
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]
- Subjects :
- 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
Subjects
Details
- Language :
- English
- ISSN :
- 10584838
- Volume :
- 75
- Issue :
- 11
- Database :
- Complementary Index
- Journal :
- Clinical Infectious Diseases
- Publication Type :
- Academic Journal
- Accession number :
- 160531909
- Full Text :
- https://doi.org/10.1093/cid/ciac303