Coronavirus Disease 2019 (COVID-19)–Related Multisystem Inflammatory Syndrome in a Pregnant Woman

Gulersen, Moti; Staszewski, Cara; Grayver, Evelina; Tam, Hima Tam; Gottesman, Eric; Isseroff, Donnie; Rochelson, Burton; Bonanno, Clarissa

doi:10.1097/aog.0000000000004256

Cited by 19 publications

(16 citation statements)

References 16 publications

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“…A total of 221 patients with MIS-A were identified: 102 were from the CDC’s MIS-C surveillance system, of whom 55 were described in a recent publication 3 ; 20 were from voluntary reports to the CDC, of whom 9 were included in a recent publication 2 ; and 99 were from case reports published in the literature. 2 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , …”

Section: Resultsmentioning

confidence: 99%

“…In total, 449 relevant articles were identified, and 86 were selected for in-depth review; of these, 60 had data for patients with MIS-A. 2 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 Figure 1 summarizes...…”

Section: Methodsmentioning

confidence: 99%

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Clinical Characteristics of Multisystem Inflammatory Syndrome in Adults

et al. 2021

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Key Points Question What are the clinical characteristics of multisystem inflammatory syndrome in adults (MIS-A)? Findings This systematic review of patients with MIS-A reported in the literature and to the US Centers for Disease Control and Prevention identified 221 patients worldwide. The syndrome presented approximately 4 weeks after acute COVID-19 with hyperinflammation and extrapulmonary multiorgan involvement that may be difficult to discern from acute biphasic COVID-19 and postacute sequelae of SARS-CoV-2 infection. Meaning These findings suggest that MIS-A occurs in the postacute COVID-19 period with a heterogeneous clinical presentation likely owing to a dysregulated immune response.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Clinical Characteristics of Multisystem Inflammatory Syndrome in Adults

et al. 2021

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“…Nasopharyngeal swab samples were tested for SARS-CoV-2 PCR yielded negative results, and the blood sample tested for SARS CoV-2 IgM + IgG antibody yielded positive results. There was no pathological sign on chest CT. A little amount of free liquid was detected in the pelvic region and among some parts of small intestine on abdomen CT. After obtaining blood, urine, and stool samples for cultures, Hékimian et al [12] Hékimian et al [12] Hékimian et al [12] Hékimian et al [12] Hékimian et al [12] Hékimian et al [12] Hékimian et al [12] Moghadam et al [13] Age ( [16] Ahsan et al [17] Malangu et al [18] Gulersen et al [19] Vieira et al [5] Razavi et al [20] Age ( Riollano-Cruz et al [21] Riollano-Cruz et al [21] Othenin-Girard [22] Parker [23] Parker [23] Kaushik et al [24] Kaushik et al [24] Chérif et al [25] Downing et al [26] Shan et al [27] Age empirical ceftriaxone 2 gr/day was started. On the follow up, hypotension, tachycardia, and hypoxia developed on the first day of treatment, and procalcitonin, troponin, and pro-BNP levels were found increased.…”

Section: Casementioning

confidence: 99%

Multiple system inflammatory syndrome associated with SARS-CoV-2 infection in an adult and an adolescent

et al. 2021

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Multisystem inflammatory syndrome in adults (MIS-A) is a new syndrome related with COVID-19. A case-based review was performed to present real-life experiences in terms of main findings and treatment options. We described two cases with the diagnosis of MIS and searched the literature to review all reported ≥ 18-year-old cases. The PubMed, Scopus, and Web of Science databases were searched. All relevant articles from January 2020 to February 2021 were reviewed. An adolescent and an adult patient (18 and 40 years-old, respectively) with the diagnosis of MIS were presented. Both had the consistent clinical findings with the case definition criteria. Although steroid, intravenous immunoglobulin (IVIG) and supportive care treatments have been suggested in the literature, there exists no treatment guideline for MIS-A. The clinical and laboratory findings of the patients progressively improved with the implementation of the IVIG and the pulse steroid treatments. A total of 51 cases (≥ 18 years-old) with MIS were analyzed. Mean age was 29.4 ± 10 years. Fever (80.4%), gastrointestinal (72.5%), and respiratory symptoms (54.9%) were the predominant symptoms. Cardiovascular abnormalities were the most frequent reported findings (82.4%, 42/51). The dermatological and conjunctival findings were reported in 39.2% and 35.3% of the patients, respectively. The increased level of inflammatory biomarkers was remarkable. Most of the patients were treated successfully with steroid and IVIG. Clinicians managing adult patients should keep in mind the development risk of MIS related with SARS-CoV-2 infection to perform necessary interventions properly without delay. IVIG and pulse steroid treatments are the effective options on clinical improvement.

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“…Severe respiratory disease requiring extra-ordinary treatment or monitoring is consistently described [2, 10, 13, 14, 19, 28, 30-33, 39-41, 43, 44, 46, 47, 59, 61, 66-91]. Cardiac disease may accompany the latter [92]. The frequencies of severe illness have been variably inclusive of 3-25% of the infected mothers, but these numbers are influenced by the variation that is inherent for admitting patients to hospitals or in the classification of disease severity at presentation or thereafter.…”

Section: Nature Of Diseasementioning

confidence: 99%

A Comprehensive Analysis of Maternal and Newborn Disease and Related Control for COVID-19

Cimolai

2021

SN Compr. Clin. Med.

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The maternal-fetal/newborn unit is established at risk for COVID-19 infection. This narrative review summarizes the contemporary and cumulative publications which detail maternal infection, antenatal and newborn infections, and maternal/fetal/newborn management and prevention. There is a wide spectrum of maternal disease, but the potential for severe disease albeit in a minority is confirmed. COVID-19 carries risk for preterm delivery. Pregnant females can suffer multisystem disease, and co-morbidities play a significant role in risk. Congenital infection has been supported by several anecdotal reports, but strong confirmatory data are few. No typical congenital dysmorphisms are evident. Nevertheless, placental vascular compromise must be considered a risk for the fetus during advanced maternal infections. Clinical manifestations of newborn infection have been mild to moderate and relatively uncommon. Proven antiviral therapy is of yet lacking. The mode of delivery is a medical decision that must include patient risk assessment and patient directives. Both presymptomatic and asymptomatic mothers and offspring can complicate infection control management with the potential for spread to others in several regards. In the interim, infections of the maternal-fetal-newborn unit must be taken seriously both for the disease so caused and the potential for further dissemination of disease.

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Coronavirus Disease 2019 (COVID-19)–Related Multisystem Inflammatory Syndrome in a Pregnant Woman

Abstract: Treatment with intravenous immunoglobin and high-dose corticosteroids was associated with rapid improvement of coronavirus disease 2019 (COVID-19)–related multisystem inflammatory syndrome in a pregnant woman.

Cited by 19 publications

References 16 publications

Clinical Characteristics of Multisystem Inflammatory Syndrome in Adults

Clinical Characteristics of Multisystem Inflammatory Syndrome in Adults

Multiple system inflammatory syndrome associated with SARS-CoV-2 infection in an adult and an adolescent

A Comprehensive Analysis of Maternal and Newborn Disease and Related Control for COVID-19

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