In rare cases, adults who have recovered from COVID-19 may develop multisystem inflammatory syndrome, and clinicians should consider this possibility in adults with specific symptoms, as physicians describe in a case published in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.210232.
A 60-year-old man, who had tested positive for SARS-CoV-2 four weeks before, visited hospital for a range of symptoms, including prolonged shortness of breath, high fever, swelling and severe fatigue. Testing found an enlarged heart and lung swelling as well as other issues.
"Given the patient's recent history of SARS-CoV-2 infection, fevers without localizing symptoms, oral mucosal changes, cervical lymphadenopathy, conjunctivitis and lower extremity changes, we suspected inflammatory post-COVID-19 syndrome. The presentation was similar to reported cases of an uncommon but severe complication in children and adolescents infected with SARS-CoV-2, called multisystem inflammatory syndrome in children (MIS-C), as well as to Kawasaki-like illness," write Drs. Genevieve Kerkerian and Stephen Vaughan, infectious disease specialists, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta.
Prompt initiation of medication helped the patient to recover.
Previous cases of the syndrome in adults have been documented in people younger than 50. The authors suggest that age should not limit the potential diagnosis.
Much is unknown about multisystem inflammatory syndrome in adults (MIS-A).
"Unlike for MIS-C, there is currently no requirement to report cases of MIS-A to provincial or state authorities, but this should be encouraged to facilitate research and improve patient outcomes," the authors conclude.
Canadian Medical Association Journal