Open AccessDiversity of Cardiac and Gastrointestinal Presentations of Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19: A Case Series
Author(s) -
Anuja Shikhare,
Rimsha M Iqbal,
Rabail Tariq,
Daniel R. Turner,
Bassam M. Gebara,
Bishara J. Freij
Publication year - 2021
Publication title -
global pediatric health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.354
H-Index - 11
ISSN - 2333-794X
DOI - 10.1177/2333794x21996613
Subject(s) - medicine , kawasaki disease , asymptomatic , aspirin , infliximab , pediatrics , pneumonia , myocarditis , immunology , disease , artery
COVID-19 is generally a benign or asymptomatic infection in children, but can occasionally be severe or fatal. Delayed presentation of COVID-19 with hyperinflammation and multi-organ involvement was recently recognized, designated the Multisystem Inflammatory Syndrome in Children (MIS-C). Six children with MIS-C with molecular and serologic evidence of SARS-CoV-2 infection were admitted to our hospital between May 5, 2020 and June 25, 2020. All had fever and weakness; 4/6 presented with gastrointestinal symptoms. Two children had features of complete Kawasaki disease, 3 had incomplete Kawasaki disease, while 1 had terminal ileitis with delayed onset of circulatory shock. Treatment consisted of intravenous immunoglobulin and aspirin for Kawasaki-like disease. Remdesivir, corticosteroids, and infliximab were used when indicated. Median hospitalization was 7 days. Immediate treatment resulted in rapid clinical improvement. In children presenting with hyperinflammatory syndromes without cardiac manifestations, testing for SARS-CoV-2 RNA and antibodies, with close cardiac monitoring should be pursued due to the manifold presentations of SARS-CoV-2 infection in children.