Журнал клинических случаев

Post-COVID-19 Multisystem Inflammatory Syndrome in a Young Adult: A Case Report

Abstract

Dichtwald Sara, Paz Yoav, Dana Elad, Fredman Brian and Chowers Michal

Background: Post-COVID-19 infection syndrome has been described in children, known as Multisystem Inflammatory Syndrome in Children temporally associated with SARS-CoV-2. Clinical signs and symptoms include conjunctivitis, rash, fever, hypotension, gastrointestinal symptoms, myocarditis and coronary abnormalities. Most case reports were described in children, and there are very few case reports of Post-COVID-19 Multisystem Inflammatory Syndrome in Adults (MIS-A). Case report: We describe a case of a healthy 21-years-old man with symptoms of fever, myalgia and loss of taste, followed by severe dyspnea and hypoxemia. Chest computed tomography scan revealed extensive bilateral lung infiltrates. Shock and acute kidney injury followed. Echocardiography showed severe left ventricular dysfunction. The patient was intubated and ventilated. Due to cardiogenic shock and hypoxemia, veno-arterial Extracorporeal Membrane Oxygenation (ECMO) therapy was initiated. A diagnosis of multisystem inflammatory syndrome due to past COVID infection was made. The patient received methylprednisolone pulse therapy and intravenous immunoglobulin therapy. His condition improved quickly, and the patient was weaned off ECMO support. Conclusion: We presented a case of severe MIS-A in a young adult, with recent asymptomatic COVID-19 infection, manifested as cardiogenic shock and pulmonary edema. As MIS-A presentation may mimic other pathologic conditions; high index of suspicion is required.