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成人与 COVID-19 相关的多系统炎症综合征:关于早期诊断和皮质类固醇治疗对预后重要性的病例系列

Multisystem Inflammatory Syndrome in Adults Associated With COVID-19: A Case Series on the Importance of Early Diagnosis and Corticosteroid Therapy in Prognosis.

作者信息

Ck Anees, C Arjun, Nedunchezian Bhubaneshwar, Srinivasan Shuba, Augustine Anitha Theresa

机构信息

Department of General Medicine, Dr. Moopen's Medical College, Wayanad, IND.

Department of General Medicine, Sri Madhusudan Sai Institute of Medical Sciences and Research, Chikkaballapur, IND.

出版信息

Cureus. 2023 Mar 13;15(3):e36068. doi: 10.7759/cureus.36068. eCollection 2023 Mar.

Abstract

Multisystem inflammatory syndrome in adults (MIS-A) is a rare condition that can occur after an adult has been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It can occur anywhere between two and 12 weeks after the beginning of acute coronavirus disease 2019 (COVID-19) infection and is characterized by extrapulmonary multiorgan failure. It is primarily seen in young and previously healthy individuals. The exact prevalence of MIS-A is unclear. It is likely underdiagnosed due to overlapping symptoms with severe COVID-19 and difficulty in identifying the syndrome without a preceding COVID-19 infection. The pathogenesis of MIS-A is also largely unknown but is likely caused by an immune response that is dysregulated or antibody-mediated. Treatment primarily involves corticosteroids, but severe cases may require intravenous immune globulin (IVIG). The timing of starting corticosteroid therapy is crucial, as delays can result in increased complications and a longer hospital stay.

摘要

成人多系统炎症综合征(MIS-A)是一种罕见病症,可在成人感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)后出现。它可在2019冠状病毒病(COVID-19)急性感染开始后的2至12周内的任何时间出现,其特征为肺外多器官功能衰竭。它主要见于年轻且既往健康的个体。MIS-A的确切患病率尚不清楚。由于其症状与重症COVID-19重叠,且在没有先前COVID-19感染的情况下难以识别该综合征,因此可能存在诊断不足的情况。MIS-A的发病机制在很大程度上也尚不清楚,但可能是由失调的免疫反应或抗体介导引起的。治疗主要涉及使用皮质类固醇,但重症病例可能需要静脉注射免疫球蛋白(IVIG)。开始皮质类固醇治疗的时机至关重要,因为延迟可能会导致并发症增加和住院时间延长。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/299d/10010151/e7cf497daac8/cureus-0015-00000036068-i01.jpg

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