Síndrome inflamatória multissistêmica (MIS-C) em criança após infecção por SARS-CoV-2

Abstract

OBJECTIVES: The multisystem inflammatory syndrome is a potentially fatal complication of coronavirus 2 (SARS-CoV-2). Since April 2020, information on a Kawasakis-like disease and inflammatory response in children, associated with severe acute respiratory syndrome SARS-CoV-2, has been related. It has been still unclear the risk factors, pathogenesis, prognosis, and therapy specific to this condition, known as multisystemic inflammatory syndrome in children (MIS-C). MIS-C usually affects children older than 5 years, predominantly of African descent, and has a higher incidence of cardiac changes (myocardite, valvulite, pericardite, and coronary abnormalities). Therefore, early recognition is crucial, although no standardized treatment guidelines have been agreed. The aim of this study is to report the management and evolution of a seriously ill child admitted to the intensive care unit (ICU) with cardiogenic shock secondary to acute myocarditis and suspected SARS-CoV-2 infection. CASE REPORT: Child, 9 years old, with SARS-CoV-2 infection, presenting initial Kawasaki disease and abrupt progression to vasoplegic shock, myocarditis, and hyperinflammation syndrome, evidenced by high levels of troponin I, ferritin, C-reactive protein (CRP), D-dimer, and hypoalbuminemia. Evolved with an excellent outcome although the need of support at pediatric intensive care unit. COMMENTS: Patients with a multisystem inflammatory response associated with previous SARS-CoV-2 infection need special and early attention regarding diagnosis and medical assistance, as for the rapid evolution of the disease as for its severity and extent.