CDC identifies novel COVID-19 syndrome in adults similar to MIS-C in children

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Adults can sometimes suffer from dangerous symptoms that resemble coronavirus syndrome in children, researchers from the U.S. Centers for Disease Control and Prevention said on Friday.

They call it multisystem inflammatory syndrome in adults, or MIS-A, and say it’s similar to multisystem inflammatory syndrome in children, or MIS-C. Like MIS-C, MIS-A is clearly unrelated to coronavirus, and people with the disease may not have any other symptoms that would indicate infection with COVID-19.

But MIS-A has killed at least three patients and, like COVID-19, disproportionately hits racial and ethnic minorities, the CDC team said.

A black man living in Florida suffered from ringing in the ears, vomiting and chest pain. He tested negative for COVID-19 when he was admitted to hospital, but died despite treatment. He was 46 years old.

A 22-year-old black woman in New York City was healthy until she developed a fever and chills, but spent 19 days in hospital before she was well enough to return home, said the CDC team.

MIS-C has affected several hundred children around the world, and if treated quickly, children will recover. It causes general inflammation, but patients usually do not have the classic symptoms of coronavirus. Blood tests indicate that MIS-C can develop weeks after a child has recovered from a coronavirus infection – usually a case that has caused mild symptoms or no symptoms.

The CDC team described the cases of 27 adults between the ages of 21 and 50 who had similar syndromes. Most had extreme inflammation throughout their bodies and dysfunction of organs, such as the heart, liver, and kidneys, but not the lungs. “Although hyperinflammation and extrapulmonary organ dysfunction have been described in hospitalized adults with severe COVID-19, these conditions are usually accompanied by respiratory failure,” they wrote in the CDC’s weekly report on the death and disease, the MMWR.

“In contrast, the patients described here had minimal respiratory symptoms, hypoxemia (low oxygen in the blood), or radiographic abnormalities as per the working case definition, which was intended to distinguish MIS-A from COVID- 19 severe; only eight out of 16 patients had documented respiratory symptoms before the onset of MIS-A. ”

A third of the 27 patients tested negative for active coronavirus infection but tested positive for antibodies, indicating that they had been infected in the past. “All but one of the MIS-A patients described in this report were from racial or ethnic minority groups,” the researchers wrote.

“Clinicians and healthcare providers should consider MIS-A in adults with compatible signs and symptoms,” the team advised. “These patients may not have positive PCR or SARS-CoV-2 antigen test results, and antibody tests may be needed to confirm a previous SARS-CoV-2 infection. ”

Symptoms include a fever that lasts 24 hours or more; patient chest and irregular heartbeat; evidence of cardiac dysfunction; gastrointestinal symptoms and rashes. X-rays can show inflammation of the lungs even if patients do not have symptoms.

The CDC said 10 of 27 patients required intensive care; three were intubated and three died. In two young adults, their first symptoms were major strokes.

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