Case Report: A case of multisystem inflammatory syndrome in an 11-year-old female after COVID-19 inactivated vaccine

Abstract

BackgroundMultisystem inflammatory syndrome in children (MIS-C), also known as pediatric inflammatory, multisystem syndrome temporally associated with SARS-CoV-2, is a rare but serious complication of SARS-CoV-2 infection in children that typically occurs 2–6 weeks after SARS-CoV-2 infection. The pathophysiology of MIS-C is unknown. MIS-C, first recognized in April 2020, is characterized by fever, systemic inflammation, and multi-system organ involvement. Post-vaccination adverse effects have increased with COVID-19 vaccinations, and MIS linked to immunization with COVID-19 vaccines has also been observed.Case ReportAn 11-year-old Chinese girl presented with a high-grade fever, rash, and dry cough for 2 days. She had her 2nd SARS-CoV-2 inactivated vaccination dose five days before hospital admission. On day 3 & 4, she experienced bilateral conjunctivitis, hypotension (66/47 mmHg), and a high CRP level. She was diagnosed with MIS-C. The patient's condition deteriorated rapidly, necessitating intensive care unit admission. The patient's symptoms improved after intravenous immunoglobulin, methylprednisolone, and oral aspirin therapy. She was discharged from the hospital after 16 days as her general condition, and laboratory biomarkers returned to normal.ConclusionInactivated Covid-19 vaccination might trigger MIS-C. Further research is needed to evaluate whether a correlation exists between COVID-19 vaccination and MIS-C development.

Multisystem Inflammatory Syndrome in Children Following COVID-19 Vaccination: A Sex-Stratified Analysis of the VAERS Database Using Brighton Collaboration Criteria

“…To date, the potential severity of MIS-c and its possible long-term sequelae represent a valid reason to vaccinate children; indeed, literature data suggest that mRNA COVID-19 vaccines decreased the likelihood of MIS-c [ 18 , 50 ]. At the same time, recent studies report suspect cases of patients developing MIS-c after anti COVID-19 vaccine administration [ 3 , 4 , 5 , 6 , 7 ]. Our findings, in line with other recent studies, highlighted that mRNA COVID-19 vaccines could be potentially associated with MIS-c; such event seems to mostly involve young males, especially after the first dose.…”

“…At the same time, in September 2021, the European Medicines Agency’s (EMA) Pharmacovigilance Risk Assessment Committee (PRAC) started the review of suspected MIS reported after the administration of anti COVID-19 vaccines in the European Economic Area (EEA) [ 2 ]. While MIS-c following Severe Acute Respiratory Syndrome–Coronavirus 2 (SARS-CoV-2) infection is well-known, little is known about COVID-19 vaccine-induced MIS-c. Only a few cases of MIS-c have been reported in the literature in subjects who had no history of SARS-CoV-2 infection [ 3 , 4 , 5 , 6 , 7 ]. These cases suggest that a possible association between the COVID-19 vaccine and MIS-c cannot be excluded, but is not yet confirmed; moreover, the pathophysiology of MIS-c is unknown and it is rarely reported.…”

“…MIS-c represents a late manifestation of SARS-CoV-2 infection which can occur 2–6 weeks after SARS-CoV-2 infection or exposure [ 8 ]. MIS-c following COVID-19 vaccination is challenging to diagnose due to a lack of diagnostic biomarkers [ 7 ]. Moreover, it is expected that some cases of MIS-C caused by SARS-CoV-2 infections acquired prior to full vaccination will occur after vaccination and will appear to be temporally associated with the vaccine.…”