Adults can also develop inflammatory syndrome after Covid-19

Adults can also develop inflammatory syndrome after Covid-19

Doctors at the University of Calgary reported the clinical case of a 60-year-old patient who presented symptoms similar to Mis-C, a rare inflammatory syndrome that affects children and adolescents recovered from Covid-19

( photo: Juraj Varga / Pixabay) Shortness of breath, high fever, widespread swelling: these are some of the symptoms of the infrequent but rather severe inflammatory syndrome that affects children and adolescents recovered from Covid-19, called Mis-C (Multisystem Inflammatory Syndrome in Children). Although it is mainly considered to be the responsibility of younger people, doctors warn against the need not to exclude it from the diagnosis in adults: a 60-year-old man, four weeks after testing positive for Sars-Cov-2 infection, was hospitalized in hospital with symptoms similar to Mis-C. The case was described by doctors from the University of Calgary in an article published in the Canadian Medical Association Journal.

Mis-C, what it is

We have already known for some time that the effects of Covid-19 are not reduced only to the persistence of the infection, but can also persist once it is is healed. Patients, in fact, can present complications such as venous thromboembolism, cardiovascular disease, acute kidney or liver damage, neurological symptoms: the possibility of suffering from Long Covid is now known, a term used to encompass all the complications that continue for a long time after having contract the virus and be cured of it. Children and adolescents, in general, are less affected, but in some cases, following Sars-Cov-2 infection, they can develop a severe form of inflammation affecting all organs, with characteristics similar to Kawasaki disease ( syndrome of unknown origin causing vasculitis and severe organ inflammation in children): As of May 3, 2021, 3,742 children in the United States were diagnosed with Mis-C. And what about adults? In October 2020, the US CDC published a review in which it identified 27 cases of adults with multisystem inflammatory syndrome, referring to it as Multisystem Inflammatory Syndrome in Adults (Mis-A). Up to this case, the (few) patients diagnosed with Mis-A were adults under the age of 50.

The clinical case

The patient presented to the emergency room with a a series of symptoms that lasted for nearly a week: prolonged shortness of breath, fever above 40 ° C, severe fatigue and swollen lymph nodes; he also presented with typical inflammatory signs such as erythema and conjunctivitis. Four weeks earlier he had tested positive for Sars-Cov-2 infection, he had no previous pathologies and had not undergone vaccination. Tests conducted by clinicians after hospitalization also revealed an enlarged heart and a beginning of pulmonary edema. The clinical picture, given the recent recovery from the viral disease, immediately alerted the doctors. "Given the patient's recent history of Sars-Cov-2 infection, fevers without localization symptoms, oral mucosal changes, cervical lymphadenopathy, conjunctivitis, and lower limb changes, we suspected a post-Covid-19 inflammatory syndrome," they write. the authors of the article Genevieve Kerkerian and Stephen Vaughan. "The clinical presentation was similar to the reported cases of multisystem inflammatory syndrome in children".


The timely intervention of clinicians in this direction allowed the patient to recover completely: i doctors first gave him acetylsalicylic acid and methylprednisolone, then intravenous immunoglobulins (drugs with an immunomodulatory effect). The treatment had the hoped-for results: after only 24 hours from the start of therapy, the man reported a significant improvement in inflammatory symptoms and general clinical parameters, and was discharged 5 days after admission.

Although in rare cases, therefore, even adults recovered from Covid-19 can develop a multisystem inflammatory syndrome, very similar to that of children and adolescents. "Since we continue to learn about Mis-A, it is prudent not to assume any age restrictions when considering the diagnosis, as our case suggests," conclude the authors of the article. A timely diagnosis means, as in the case of the Canadian patient, a targeted and more effective treatment.

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