Multisystem inflammatory syndrome in children (MIS-C) showing disseminated aspergillosis, cytomegalovirus reactivation and persistent SARS-COV-2: Case report with autopsy review

Taweevisit, Mana; Chindamporn, Ariya; Sujjavorakul, Kritsaporn; Samransamruajkit, Rujipat; Thorner, Paul

doi:10.1016/j.prp.2022.154106

Cited by 8 publications

(18 citation statements)

References 33 publications

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“…Conversely, it is easier to understand the gastro-intestinal symptoms like diarrhea, vomiting, nausea, stomach and abdominal pain, which were particularly common at all different timepoints, especially in males and children over 10 years old. This data was not unexpected, given the growing understanding on the role of the GI tract as a site of latency for the virus, or at least parts of it [1, [10][11][12]. Several reports have reported that SARS-CoV-2 can be detected in stools for months after the acute phase of the illness, even when the virus cannot be detected in the respiratory tract anymore.…”

Section: Discussionmentioning

confidence: 92%

The Prevalence, Characteristics and Risk Factors of Persistent Symptoms in Non-Hospitalized and Hospitalized Children with SARS-CoV-2 Infection Followed-Up for up to 12 Months: A Prospective, Cohort Study in Rome, Italy

Buonsenso

Pazukhina

Gentili

et al. 2022

JCM

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Previous studies assessing the prevalence of COVID-19 sequelae in children have included either a small number of children or a short follow-up period, or have only focused on hospitalized children. We investigated the prevalence of persistent symptoms amongst children and assessed the risk factors, including the impact of variants. A prospective cohort study included children (≤18 years old) with PCR-confirmed SARS-CoV-2 infection. The participants were assessed via telephone and face-to-face visits at 1–5, 6–9 and 12 or more months post-SARS-CoV-2 diagnosis using the ISARIC COVID-19 follow-up survey. Of the 679 children enrolled, 51% were female; 488 were infected during the wild virus wave, and 29 were infected with the Alpha, 42 with the Delta and 120 with the Omicron variants. Fatigue (19%), headache (12%), insomnia (7.5%), muscle pain (6.9%) and confusion with concentration issues (6.8%) were the most common persistent symptoms. Families reported an overall improvement over time, with 0.7% of parents interviewed at 12 months or more of the follow-up period reporting a poor recovery. Patients that had not recovered by 6–9 months had a lower probability of recovering during the next follow-up period. Children infected with a variant or the wild virus had an overall similar rate of persistent symptoms (although the pattern of reported symptoms differed significantly) and recovery rates. Conclusions: Recovery rates after SARS-CoV-2 infection improved as time passed from the initial infection, ranging from 4% of children having poor recovery at 1–5 months’ follow-up to 1.3% at 6–9 months and 0.7% at 12 months. The patterns of persistence changed according to the variants involved at the time of infection. This study reinforces that a subgroup of children develop long-lasting persistent symptoms and highlights the need for further studies investigating the reasons behind the development of PCC.

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Section: Discussionmentioning

confidence: 92%

The Prevalence, Characteristics and Risk Factors of Persistent Symptoms in Non-Hospitalized and Hospitalized Children with SARS-CoV-2 Infection Followed-Up for up to 12 Months: A Prospective, Cohort Study in Rome, Italy

Buonsenso

Pazukhina

Gentili

et al. 2022

JCM

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“…The lymph node biopsy findings were of particular interest, as we were able to demonstrate the persistence of SARS-CoV-2 in macrophages. Although we were not able to assess viral load in the tissue or determine its viability, the positive immunohistochemistry results suggest that there may be a persistent inflammatory stimulus that triggers the immune system, thereby contributing to the pathophysiology of MIS-A [ 11 , 15 ]. Our finding is consistent with that of previous reported cases on MIS-C, which showed SARS-CoV-2 persistence [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Concomitant Cytomegalovirus Viraemia in Multisystem Inflammatory Syndrome in Adults (MIS-A) following COVID-19

Valente-Acosta,

Moreno-Sánchez,

Neme-Yunes

et al. 2024

Case Reports in Infectious Diseases

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Multisystem inflammatory syndrome in adults (MIS-A) is recognised as an infrequent complication of coronavirus disease 2019 (COVID-19). This syndrome occurs following COVID-19 infection in some individuals and is characterised by inflammation of multiple organ systems, such as the heart, liver, bowel, and lymph nodes. Cytomegalovirus (CMV) viraemia is associated primarily with immunosuppression. In COVID-19 patients, it has been reported in severe and critical cases. We present a case of an adult patient diagnosed with MIS-A and concomitant CMV viraemia.

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“…The diverse cells expressing the ACE-2 receptor can render them vulnerable to SARS-CoV-2 infection. This broad viral target might explain acute infection symptoms, yet the exact mechanism leading to prolonged symptoms remains unclear ( 218 , 219 ). Although different cell targets of infection could elucidate acute symptoms, the mechanism behind the transition from acute to prolonged symptoms remains unclear ( 218 ).…”

Section: Pathophysiology Of Long Covidmentioning

confidence: 99%

Pathophysiological, immunological, and inflammatory features of long COVID

Bohmwald,

Diethelm-Varela,

Rodríguez-Guilarte

et al. 2024

Front. Immunol.

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The COVID-19 pandemic continues to cause severe global disruption, resulting in significant excess mortality, overwhelming healthcare systems, and imposing substantial social and economic burdens on nations. While most of the attention and therapeutic efforts have concentrated on the acute phase of the disease, a notable proportion of survivors experience persistent symptoms post-infection clearance. This diverse set of symptoms, loosely categorized as long COVID, presents a potential additional public health crisis. It is estimated that 1 in 5 COVID-19 survivors exhibit clinical manifestations consistent with long COVID. Despite this prevalence, the mechanisms and pathophysiology of long COVID remain poorly understood. Alarmingly, evidence suggests that a significant proportion of cases within this clinical condition develop debilitating or disabling symptoms. Hence, urgent priority should be given to further studies on this condition to equip global public health systems for its management. This review provides an overview of available information on this emerging clinical condition, focusing on the affected individuals’ epidemiology, pathophysiological mechanisms, and immunological and inflammatory profiles.

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Multisystem inflammatory syndrome in children (MIS-C) showing disseminated aspergillosis, cytomegalovirus reactivation and persistent SARS-COV-2: Case report with autopsy review

Cited by 8 publications

References 33 publications

The Prevalence, Characteristics and Risk Factors of Persistent Symptoms in Non-Hospitalized and Hospitalized Children with SARS-CoV-2 Infection Followed-Up for up to 12 Months: A Prospective, Cohort Study in Rome, Italy

The Prevalence, Characteristics and Risk Factors of Persistent Symptoms in Non-Hospitalized and Hospitalized Children with SARS-CoV-2 Infection Followed-Up for up to 12 Months: A Prospective, Cohort Study in Rome, Italy

Concomitant Cytomegalovirus Viraemia in Multisystem Inflammatory Syndrome in Adults (MIS-A) following COVID-19

Pathophysiological, immunological, and inflammatory features of long COVID

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