Neonatal Multisystem Inflammatory Syndrome (MIS-N) Associated with Maternal SARS-CoV-2 Exposure

Gupta, Pallavi; B., Subhash Arun; Tamatam, Prasen Reddy; Dhulipudi, Bhargavi; Vardhelli, Venkateshwarlu; Deshabhotla, Saikiran; Oleti, Tejo Pratap

doi:10.1007/s12098-022-04167-3

Cited by 10 publications

(6 citation statements)

References 4 publications

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“…Of the 57 patients analyzed in this literature search, 6 had a fatal outcome [ 4 , 12 , 13 ] and 1 underwent limb amputation [ 9 ]. Cardiac involvement (left ventricular dysfunction mentioned in six patients), cardiogenic shock, pericardial effusion and pulmonary hemorrhage were present in 12, 2, 2 and 1 reports, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Differences may be found in the analyzed relevant literature in respect to the presence of cardiac shock [ 4 , 6 , 10 , 15 ], aortic and intra-cardiac thrombosis [ 9 , 12 ], pericardial effusion [ 11 ] and coronary artery dilations [ 4 , 7 ]. None of our cases had clinical manifestations of cardiac involvement, and no ultrasound modifications raised the possibility of MISC-N-related myocarditis.…”

Section: Discussionmentioning

confidence: 99%

“…In order to complete this literature review, we used PubMed and Google Scholar as search engines. The keywords used were MISC-N, neonates and COVID-19; newborns; and MIS-C. A total of 17 case reports or case series (57 newborns were included) were retrieved ( Supplementary Table S1 ) [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 ]. The number of patients included in the case series ranged from 2 to 20 newborns.…”

Section: Methodsmentioning

confidence: 99%

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Early Outcome of Multisystem Inflammatory Syndrome in Neonates Diagnosed following Prenatal Maternal COVID-19 Infection: A Three-Case Series

Terciu,

Luca,

Panait

et al. 2023

Pediatric Reports

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Background: The aim of this case series report is to evaluate the characteristics of multisystem inflammatory syndrome (MIS) in neonates following prenatal maternal COVID-19 infection. Methods: We present a case series of three newborns (≤28 days of age) diagnosed with MIS due to the vertical transmission of SARS-CoV2 infection and admitted from 1 January 2021 to 1 June 2023. The inclusion criteria were negative RT-PCR-SARS-CoV-2 test in infants, initial negative IgM-SARS-CoV-2 in infants followed by the emergence of positive IgG-SARS-CoV-2 antibodies in infants and maternal COVID-19 infection in the third trimester of pregnancy. Patients enrolled in this case series were admitted due to acute febrile illnesses. Results: All three cases occurred in patients born at a mean gestational age of 39 weeks and who were appropriate for gestational age. The mean age at admission was 18.3 days. Fibrinogen (>400 mg/dL) and ferritin (>120 mg/dL) were elevated above the upper normal limit. Elevated levels of myocardial biomarkers (D-dimers, N-terminal pro b-type natriuretic peptide troponin T and creatine phosphokinase myocardial band) were recorded, with normal heart function evaluated using echocardiography. All three patients were treated with antibiotics; one received intravenous immunoglobulin. A 4-week follow-up was completed in two patients when their myocardial biomarkers and ferritin were still elevated but lower compared with previous examinations. D-dimers levels were normalized in 2/3 patients. Conclusions: Subclinical myocarditis was diagnosed as an early outcome in infants with MIS diagnosed postnatally due to the vertical transmission of SARS-CoV2 infection and may represent a new challenge for pediatricians in the pandemic era.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Early Outcome of Multisystem Inflammatory Syndrome in Neonates Diagnosed following Prenatal Maternal COVID-19 Infection: A Three-Case Series

Terciu,

Luca,

Panait

et al. 2023

Pediatric Reports

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“…Symptoms of MIS-N appear to be broad, including thrombotic and neurologic events, respiratory distress, gastrointestinal symptoms, kidney failure, and septic features. The most reported feature is cardiac dysfunction (78% of cases), including arrhythmias, aneurysms, and pericardial effusions (2,(5)(6)(7)(8)(9)(10). Fever is less common, reported in one third of patients only (2,8,9).…”

Section: Svoa Paediatricsmentioning

confidence: 99%

Case Report of An Extreme Premature Infant with Multisystem Inflammatory Syndrome in Neonates (MIS-N)

Karroum,

Fakhreddine,

Adesanya

2023

SVOAPD

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COVID-19 pandemic hit the world hard affecting more than 500 million people. In the SARS-CoV-2 pandemic era, there has been various information on the effect of COVID-19 infected or exposed pregnant women on their neonates. SARS-CoV-2 virus causes a hyperinflammatory syndrome in neonates similar to what may be seen in multisystem inflammatory syndrome in children (MIS-C) but due to transplacental transfer of antibodies rather than a neonatal infection with COVID-19. Case reports about a new pattern of disease, called multisystem inflammatory syndrome of neonate (MIS-N), have been recently appearing. We reviewed the perinatal history, clinical features, and outcomes of a preterm neonate with features consistent with MIS-N related to maternal SARS-CoV-2 infection that was managed in Texas, United States, in 2022. The infant presented with multisystem organ failure at 12 to 15 days of life. All extensive work up for infectious causes on the neonate were negative. Her inflammatory biomarkers were elevated, and she improved with steroids and supportive treatment. The neonate’s anti-SARS-CoV-2 IgG was positive and the IgM was negative. Though rare, we speculate that maternal SARS-CoV-2 and other autoantibodies crossing the placenta caused MIS-N. Further studies and reviews are needed to evaluate pathophysiology and to further evaluate the available treatments.

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Section: Svoa Paediatricsmentioning

confidence: 99%

Untitled

2023

SVOAPD

View full text Add to dashboard Cite

COVID-19 pandemic hit the world hard affecting more than 500 million people. In the SARS-CoV-2 pandemic era, there has been various information on the effect of COVID-19 infected or exposed pregnant women on their neonates. SARS-CoV-2 virus causes a hyperinflammatory syndrome in neonates similar to what may be seen in multisystem inflammatory syndrome in children (MIS-C) but due to transplacental transfer of antibodies rather than a neonatal infection with COVID-19. Case reports about a new pattern of disease, called multisystem inflammatory syndrome of neonate (MIS-N), have been recently appearing. We reviewed the perinatal history, clinical features, and outcomes of a preterm neonate with features consistent with MIS-N related to maternal SARS-CoV-2 infection that was managed in Texas, United States, in 2022. The infant presented with multisystem organ failure at 12 to 15 days of life. All extensive work up for infectious causes on the neonate were negative. Her inflammatory biomarkers were elevated, and she improved with steroids and supportive treatment. The neonate's anti-SARS-CoV-2 IgG was positive and the IgM was negative. Though rare, we speculate that maternal SARS-CoV-2 and other autoantibodies crossing the placenta caused MIS-N. Further studies and reviews are needed to evaluate pathophysiology and to further evaluate the available treatments.

show abstract

Neonatal Multisystem Inflammatory Syndrome (MIS-N) Associated with Maternal SARS-CoV-2 Exposure

Cited by 10 publications

References 4 publications

Early Outcome of Multisystem Inflammatory Syndrome in Neonates Diagnosed following Prenatal Maternal COVID-19 Infection: A Three-Case Series

Early Outcome of Multisystem Inflammatory Syndrome in Neonates Diagnosed following Prenatal Maternal COVID-19 Infection: A Three-Case Series

Case Report of An Extreme Premature Infant with Multisystem Inflammatory Syndrome in Neonates (MIS-N)

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