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Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    Unusual Presentation of Kawasaki Disease MESHD with Multisystem Inflammation MESHD and Antibodies SERO Against Severe Acute Respiratory Syndrome MESHD Coronavirus 2: A Case Report

    Authors: Haena Kim; Jung Yeon Shim; Jae-Hoon Ko; Aram Yang; Jae Won Shim; Deok Soo Kim; Hye Lim Jung; Ji Hee Kwak; In Suk Sol

    doi:10.21203/rs.3.rs-41276/v1 Date: 2020-07-12 Source: ResearchSquare

    Background: Since mid-April 2020, cases of multisystem inflammatory syndrome MESHD in children TRANS (MIS-C) associated with coronavirus disease MESHD (COVID-19) that mimic Kawasaki disease MESHD (KD) have been reported in Europe and North America. However, no cases have been in East Asia, where KD is more prevalent.Case presentation: A previously healthy 11-year-old boy was admitted with a 4-day history of fever MESHD fever HP and abdominal pain MESHD abdominal pain HP. He had no contact history to any patient with COVID-19. Blood SERO acute inflammatory markers were highly elevated. He was treated with antibiotics for suspected bacterial enteritis MESHD, but he suddenly developed hypotension MESHD hypotension HP. Inotropics and intravenous immunoglobulin were administered to manage septic shock MESHD shock HP. On hospitalization day 6, he developed signs and symptoms MESHD of KD (conjunctival injection, strawberry tongue HP, cracked lip, and coronary artery dilatation HP) in addition to pleural/ pericardial effusion MESHD pericardial effusion HP and mesenteric lymphadenitis MESHD lymphadenitis HP. The results of microbiologic tests, including reverse-transcription polymerase chain reaction for severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2), were negative. Fluorescent immunoassay SERO and enzyme-linked immunosorbent assay SERO revealed abundant IgG antibodies SERO against SARS-CoV-2 in his serum SERO, but no IgM antibodies SERO. He was discharged successfully on day 13.Conclusion: MIS-C may occur in children TRANS with a previously asymptomatic TRANS COVID-19 infection MESHD. A high index of suspicion is required for this novel syndrome MESHD in unusual cases of KD or KD shock MESHD shock HP syndrome MESHD with multisystem inflammation MESHD, even when there is no clear history of contact or symptoms of COVID-19.

    Life-threatening cardiogenic shock MESHD cardiogenic shock HP in a pediatric patient with SARS-CoV-2-associated myocarditis MESHD myocarditis HP treated with remdesivir: a case description and report of similar cases from the Literature

    Authors: Silvia Molinari; Lucia M.D. Colasanto; Maria L. Melzi; Alessandro Cattoni; Roberto Panceri; Michela Bombino; Giuseppe Lapadula; Andrea Biondi

    doi:10.21203/rs.3.rs-34802/v1 Date: 2020-06-12 Source: ResearchSquare

    BackgroundChildren are relatively spared from Coronavirus disease MESHD 2019 (COVID-19), but some severe cases have been reported. Severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) infection MESHD in children TRANS may affect the cardiovascular system. We hereby report about a case of myocarditis MESHD myocarditis HP evolving to cardiogenic shock MESHD cardiogenic shock HP in a SARS-CoV-2 positive child TRANS.Case presentationAn otherwise healthy 12-year-old patient was admitted with fever MESHD fever HP, vomiting MESHD vomiting HP, diarrhoea and drowsiness HP, without any respiratory symptoms. He was diagnosed with COVID-19 on nasopharyngeal swab. He developed hypotension MESHD hypotension HP and cardiogenic shock MESHD cardiogenic shock HP. Bedside echocardiography revealed left ventricular impairment with an ejection fraction (LVEF) below 25%. Plasmatic markers of myocardial injury were remarkably raised, as well as inflammatory biomarkers, including procalcitonin (highest recorded value: 66 ng/mL) and interleukin-6 (8209 pg/mL). The child TRANS was transferred to Intensive Care Unit and he was treated with catecholamine support, mechanical ventilation and empiric anti-infectious therapy, including broad spectrum antibiotics and the antiviral agent remdesivir. All additional microbiological investigations yielded negative results. We observed a gradual improvement of LVEF within 5 days. A cardiac magnetic resonance confirmed the suspicion of myocarditis MESHD myocarditis HP. After 21 days of hospitalisation, the child TRANS was discharged without sequelae.ConclusionsOur hypothesis is that the child TRANS suffered from SARS-CoV-2-induced fulminant myocarditis MESHD myocarditis HP, probably in the setting of cytokine release syndrome MESHD (CRS). The peculiarity of this SARS-CoV-2 infection MESHD is the presence of cardiac failure in a previously healthy child TRANS without a respiratory illness. The positive outcome is in line with published Literature about the overall better prognosis of COVID-19 children TRANS compared to adults TRANS. Remdesivir, an investigational antiviral therapy, may have played a role on the clinical improvement of the child TRANS.

The ZB MED preprint Viewer preVIEW includes all COVID-19 related preprints from medRxiv and bioRxiv, from ChemRxiv, from ResearchSquare, from arXiv and from Preprints.org and is updated on a daily basis (7am CET/CEST).

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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