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http://dx.doi.org/10.14776/piv.2022.29.e20

Severe SARS-CoV-2 Infection With Multiorgan Involvement Followed by MIS-C in an Adolescent  

Bomi Lim (Department of Pediatrics, Seoul National University Children's Hospital)
Su-Mi Shin (Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center)
Mi Seon Han (Department of Pediatrics, Seoul Metropolitan Government-Seoul National University Boramae Medical Center)
Publication Information
Pediatric Infection and Vaccine / v.29, no.3, 2022 , pp. 155-160 More about this Journal
Abstract
Children and adolescents with coronavirus disease 2019 (COVID-19) generally have mild symptoms. Severe infection due to severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) involving multiorgan dysfunction is rare in this population. Herein, we present an unusual case of severe SARS-CoV-2 infection with multiorgan involvement followed by multisystem inflammatory syndrome in children (MIS-C) in a vaccinated 16-year-old boy. The patient was unconscious on initial presentation, and had severe paralytic ileus. On laboratory examination, there was severe metabolic acidosis, lymphocytopenia, thrombocytopenia, elevated inflammatory markers, elevated liver enzymes, and evidence of acute kidney injury with proteinuria and hematuria. His symptoms improved with the administration of remdesivir and dexamethasone. The patient briefly experienced MIS-C 2 weeks after the diagnosis of COVID-19, but the patient was discharged without any complications.
Keywords
COVID-19; MIS-C associated with COVID-19; SARS-CoV-2; Children;
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1 Hoffmann M, Kleine-Weber H, Schroeder S, Kruger N, Herrler T, Erichsen S, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell 2020;181:271-280.e8.    DOI
2 Chou J, Thomas PG, Randolph AG. Immunology of SARS-CoV-2 infection in children. Nat Immunol 2022;23:177-85. 
3 Nemani K, Li C, Olfson M, Blessing EM, Razavian N, Chen J, et al. Association of psychiatric disorders with mortality among patients with COVID-19. JAMA Psychiatry 2021;78:380-6.    DOI
4 Mokhtari R, Lachman HM. The major histocompatibility complex (MHC) in schizophrenia: a review. J Clin Cell Immunol 2016;7:479. 
5 Steiner J, Jacobs R, Panteli B, Brauner M, Schiltz K, Bahn S, et al. Acute schizophrenia is accompanied by reduced T cell and increased B cell immunity. Eur Arch Psychiatry Clin Neurosci 2010;260:509-18.    DOI
6 De Leon J, Sanz EJ, De Las Cuevas C. Data from the World Health Organization's pharmacovigilance database supports the prominent role of pneumonia in mortality associated with clozapine adverse drug reactions. Schizophr Bull 2020;46:1-3.    DOI
7 Centers for Disease Control and Prevention. Information for healthcare providers about multisystem inflammatory syndrome in children (MIS-C) [Internet]. Atlanta: Centers for Disease Control and Prevention; 2021 [cited 2022 May 24]. Available from: https://www.cdc.gov/mis-c/hcp/. 
8 Kaushik A, Gupta S, Sood M, Sharma S, Verma S. A systematic review of multisystem inflammatory syndrome in children associated with SARS-CoV-2 infection. Pediatr Infect Dis J 2020;39:e340-6.     DOI
9 Cui X, Zhao Z, Zhang T, Guo W, Guo W, Zheng J, et al. A systematic review and meta-analysis of children with coronavirus disease 2019 (COVID-19). J Med Virol 2021;93:1057-69.    DOI
10 Irfan O, Muttalib F, Tang K, Jiang L, Lassi ZS, Bhutta Z. Clinical characteristics, treatment and outcomes of paediatric COVID-19: a systematic review and meta-analysis. Arch Dis Child 2021;106:440-8.    DOI
11 Kompaniyets L, Agathis NT, Nelson JM, Preston LE, Ko JY, Belay B, et al. Underlying medical conditions associated with severe COVID-19 illness among children. JAMA Netw Open 2021;4:e2111182. 
12 Fernandes DM, Oliveira CR, Guerguis S, Eisenberg R, Choi J, Kim M, et al. Severe acute respiratory syndrome coronavirus 2 clinical syndromes and predictors of disease severity in hospitalized children and youth. J Pediatr 2021;230:23-31.e10.    DOI
13 Beaudry JT, Dietrick B, Lammert DB, Constas A, McCaw J, Hammond J, et al. Fatal SARS-CoV-2 inflammatory syndrome and myocarditis in an adolescent: a case report. Pediatr Infect Dis J 2021;40:e72-6.    DOI
14 Shekerdemian LS, Mahmood NR, Wolfe KK, Riggs BJ, Ross CE, McKiernan CA, et al. Characteristics and outcomes of children with coronavirus disease 2019 (COVID-19) infection admitted to US and Canadian pediatric intensive care units. JAMA Pediatr 2020;174:868-73.    DOI
15 Centers for Disease Control and Prevention. CDCHAN-00432, May 14, 2020. Multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19) [Internet]. Atlanta: Centers for Disease Control and Prevention; 2020 [cited 2022 May 24]. Available from: https://emergency.cdc.gov/han/2020/han00432.asp. 
16 Lindan CE, Mankad K, Ram D, Kociolek LK, Silvera VM, Boddaert N, et al. Neuroimaging manifestations in children with SARS-CoV-2 infection: a multinational, multicentre collaborative study. Lancet Child Adolesc Health 2021;5:167-77. 
17 Bjornstad EC, Seifert ME, Sanderson K, Feig DI. Kidney implications of SARS-CoV2 infection in children. Pediatr Nephrol 2022;37:1453-67.    DOI
18 Dallan C, Romano F, Siebert J, Politi S, Lacroix L, Sahyoun C. Septic shock presentation in adolescents with COVID-19. Lancet Child Adolesc Health 2020;4:e21-3.    DOI
19 Joshi K, Kaplan D, Bakar A, Jennings JF, Hayes DA, Mahajan S, et al. Cardiac dysfunction and shock in pediatric patients with COVID-19. JACC Case Rep 2020;2:1267-70.    DOI
20 Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, et al. Extrapulmonary manifestations of COVID-19. Nat Med 2020;26:1017-32.    DOI