Multisystem Inflammatory Syndrome in Neonates (MIS-N) in very-preterm quadruplets born to a mother with SARS CoV-2 infection in Colombo, Sri Lanka

Wickramaratne, Sangeetha; Gamaathige, Nalin; Lucas, Nishani

doi:10.4038/sljch.v51i2.10148

Sri Lanka J Child Health

2022

DOI: 10.4038/sljch.v51i2.10148

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Multisystem Inflammatory Syndrome in Neonates (MIS-N) in very-preterm quadruplets born to a mother with SARS CoV-2 infection in Colombo, Sri Lanka

Sangeetha Wickramaratne¹,

Nalin Gamaathige²,

Nishani Lucas³

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Case Series of Multisystem Inflammatory Syndrome in Neonates (MIS-N) With a Link to Coagulopathy

Siramdas,

Anudeep,

Subramanian

et al. 2023

Cureus

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IntroductionMultisystem inflammatory syndrome in neonates (MIS-N) is an emerging clinical entity observed in neonates born to mothers with exposure to the SARS-CoV-2 virus before or during the antenatal period. MethodsWe report 18 neonates diagnosed with MIS-N from retrospectively collected data. A total of 18 neonates (13 term and five late-preterm; 10 males) admitted to the neonatal intensive care unit (NICU) of a tertiary care medical institute, between June 2021 to November 2022, were diagnosed with MIS-N. ResultsThe median age of presentation of the 18 neonates was 1.5 days of life. All the neonates were positive for SARS-CoV-2 IgG antibodies and had elevated D-dimer levels. Respiratory system involvement was the most common (12 of 18 neonates: 66.67%). Ten out of 18 neonates (55.55%) had coagulopathy. Seven of the ten neonates with coagulopathy had central nervous system (CNS) involvement as seizures and/or intracerebral infarcts/bleeds. Cardiovascular and gastrointestinal system involvement was observed in nine (50%) and seven (38.89%) neonates, respectively. One out of 18 neonates died due to intraventricular and cerebral hemorrhage. The mortality rate was 5.55% (n=1). Ten of 18 neonates with coagulopathy required fresh frozen plasma along with repeated therapeutic doses of injection vitamin K. Eight neonates (44.44%) required human intravenous immunoglobulin (IVIG), and three neonates (16.67%) required steroids and IVIG for recovery along with supportive care. ConclusionCoagulopathy can be one of the salient features of presentation in MIS-N. In the immediate post-pandemic era, it is essential that MIS-N is considered in the differential diagnosis of neonates presenting with intracerebral bleeds/infarcts. IVIG and steroids might play an important role in the treatment of neonates with MIS-N.

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Case Series of Multisystem Inflammatory Syndrome in Neonates (MIS-N) With a Link to Coagulopathy

Siramdas,

Anudeep,

Subramanian

et al. 2023

Cureus

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show abstract

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Multisystem Inflammatory Syndrome in Neonates (MIS-N) in very-preterm quadruplets born to a mother with SARS CoV-2 infection in Colombo, Sri Lanka

Cited by 1 publication

References 0 publications

Case Series of Multisystem Inflammatory Syndrome in Neonates (MIS-N) With a Link to Coagulopathy

Case Series of Multisystem Inflammatory Syndrome in Neonates (MIS-N) With a Link to Coagulopathy

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