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成人多系统炎症综合征:一种罕见的 SARS-CoV-2 感染后遗症。

Multisystem inflammatory syndrome in adults: A rare sequela of SARS-CoV-2 infection.

机构信息

Creighton University Medical Center - Bergan Mercy, 7500 Mercy Road, Omaha, NE 68124, USA.

Creighton University Medical Center - Bergan Mercy, 7500 Mercy Road, Omaha, NE 68124, USA.

出版信息

Int J Infect Dis. 2021 Jul;108:209-211. doi: 10.1016/j.ijid.2021.05.050. Epub 2021 May 24.

Abstract

Multisystem inflammatory syndrome in adults (MIS-A) came to attention back in June 2020, when the United States Center for Disease Control and Prevention (CDC) received initial reports regarding patients who had presented delayed and multisystem involvement of the disease, with clinical course resembling multisystem inflammatory syndrome in children (MIS-C). This study introduces a case of MIS-A, where the patient presented 3 weeks after initial COVID-19 exposure. His clinical course was consistent with the working definition of MIS-A as specified by the CDC. Aggressive supportive care in the intensive care unit, utilization of advanced heart failure devices, and immunomodulatory therapeutics (high-dose steroids, anakinra, intravenous immunoglobulin) led to clinical recovery. Management of MIS-A is a topic of ongoing research and needs more studies to elaborate on treatment modalities and clinical predictors.

摘要

成人多系统炎症综合征(MIS-A)于 2020 年 6 月引起关注,当时美国疾病控制与预防中心(CDC)收到了最初的报告,涉及出现延迟和多系统受累的疾病的患者,其临床过程类似于儿童多系统炎症综合征(MIS-C)。本研究介绍了一例 MIS-A 患者,他在初次感染 COVID-19 后 3 周出现症状。他的临床过程符合 CDC 规定的 MIS-A 工作定义。在重症监护病房接受强化支持性护理、使用先进的心衰设备和免疫调节治疗(大剂量类固醇、阿那白滞素、静脉注射免疫球蛋白)导致临床康复。MIS-A 的管理是一个正在进行的研究课题,需要更多的研究来阐述治疗方式和临床预测因素。

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