Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA, 30322, USA.
BMC Infect Dis. 2020 Sep 29;20(1):716. doi: 10.1186/s12879-020-05439-z.
A healthy 25-year-old woman developed COVID-19 disease with clinical characteristics resembling Multisystem Inflammatory Syndrome in Children (MIS-C), a rare form of COVID-19 described primarily in children under 21 years of age.
The patient presented with 1 week of weakness, dyspnea, and low-grade fevers, followed by mild cough, sore throat, vomiting, diarrhea, and lymph node swelling. She was otherwise healthy, with no prior medical history. Her hospital course was notable for profound acute kidney injury, leukocytosis, hypotension, and cardiac dysfunction requiring ICU admission and vasopressor support. MIS-C-like illness secondary to COVID-19 was suspected due to physical exam findings of conjunctivitis, mucositis, and shock. She improved following IVIG, aspirin, and supportive care, and was discharged on hospital day 5.
MIS-C-like illness should be considered in adults presenting with atypical clinical findings and concern for COVID-19. Further research is needed to support the role of IVIG and aspirin in this patient population.
一位 25 岁健康女性出现了类似于儿童多系统炎症综合征(MIS-C)的 COVID-19 临床特征,这是一种罕见的 COVID-19 形式,主要发生在 21 岁以下的儿童中。
患者出现了 1 周的乏力、呼吸困难和低热,随后出现轻度咳嗽、喉咙痛、呕吐、腹泻和淋巴结肿大。她身体状况良好,没有既往病史。她的住院过程中出现了严重的急性肾损伤、白细胞增多、低血压和心功能障碍,需要入住 ICU 并接受血管加压支持。由于体格检查发现结膜炎、粘膜炎和休克,怀疑为 COVID-19 引起的类似于 MIS-C 的疾病。她接受 IVIG、阿司匹林和支持性治疗后有所改善,并在住院第 5 天出院。
对于出现非典型临床特征并怀疑 COVID-19 的成年人,应考虑类似于 MIS-C 的疾病。需要进一步的研究来支持 IVIG 和阿司匹林在这一患者人群中的作用。