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Elsaid M, Nune A, Hesham D, Fouad FM, Hassan H, Hamouda H, Sherif H, Abdelwahab MM, Hegazi N, El-Rahman YA. Multisystem Inflammatory Syndrome (MIS) following SARS-CoV-2 vaccinations; a systematic review. Trop Dis Travel Med Vaccines 2023; 9:19. [PMID: 37925466 PMCID: PMC10625711 DOI: 10.1186/s40794-023-00204-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/29/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Although SARS-CoV-2 vaccines are generally safe, there are growing concerns about their link to a potentially life-threatening multi-system inflammatory syndrome following vaccination (MIS-V). We conducted this systematic review to elucidate the prevalence of MIS, severity, treatment, and outcomes following SARS-CoV-2 vaccination. METHODS We searched PubMed, Scopus, ScienceDirect, Google Scholar, Virtual Health Library (VHL), Cochrane Library, and Web of Science databases for articles and case reports about MIS-V. We performed a qualitative analysis of individual cases from the included studies. RESULTS Of the 1366 studies identified by database search, we retrieved twenty-six case reports and two cohort studies. We analyzed the data of 37 individual cases extracted from 27 articles. The average age of the cases included in this review was 18 (1-67) years, with the most being male (M: F 3.1:1). Of the 37 included cases, the cardiovascular system was the most affected system by MIS (36, 97.3%), followed by the gastrointestinal tract (32, 86.5%). CONCLUSION MIS after SARS-CoV-2 vaccinations can be fatal, but the incidence is low. Prompt recognition of MIS and ruling out the mimickers are critical in the patient's early recovery.
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Affiliation(s)
- Mohamed Elsaid
- Faculty of Medicine, 6Th of October, Misr University for Science and Technology, Giza, Egypt.
- Medical Research Platform, Giza, Egypt.
| | - Arvind Nune
- Department of Rheumatology and General Medicine, Southport and Ormskirk Hospital NHS Trust, Southport, UK.
| | - Deyaa Hesham
- Medical Research Platform, Giza, Egypt
- Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
| | - Fatma Mohamed Fouad
- Medical Research Platform, Giza, Egypt
- Faculty of Science, Cairo University, Giza, Egypt
- Biology Department, College of Science, Sultan Qaboos University, Muscat, Oman
| | - Hamsa Hassan
- Medical Research Platform, Giza, Egypt
- Faculty of Pharmacy, Mansoura University, Mansoura, Egypt
| | - Heba Hamouda
- Medical Research Platform, Giza, Egypt
- Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Huda Sherif
- Medical Research Platform, Giza, Egypt
- Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Maya Magdy Abdelwahab
- Medical Research Platform, Giza, Egypt
- Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Nourelhoda Hegazi
- Medical Research Platform, Giza, Egypt
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Yasmena Abd El-Rahman
- Medical Research Platform, Giza, Egypt
- Faculty of Medicine, Portsaid University, Portsaid, Egypt
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2
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Sarmiento Varón L, González-Puelma J, Medina-Ortiz D, Aldridge J, Alvarez-Saravia D, Uribe-Paredes R, Navarrete MA. The role of machine learning in health policies during the COVID-19 pandemic and in long COVID management. Front Public Health 2023; 11:1140353. [PMID: 37113165 PMCID: PMC10126380 DOI: 10.3389/fpubh.2023.1140353] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 03/20/2023] [Indexed: 04/29/2023] Open
Abstract
The ongoing COVID-19 pandemic is arguably one of the most challenging health crises in modern times. The development of effective strategies to control the spread of SARS-CoV-2 were major goals for governments and policy makers. Mathematical modeling and machine learning emerged as potent tools to guide and optimize the different control measures. This review briefly summarizes the SARS-CoV-2 pandemic evolution during the first 3 years. It details the main public health challenges focusing on the contribution of mathematical modeling to design and guide government action plans and spread mitigation interventions of SARS-CoV-2. Next describes the application of machine learning methods in a series of study cases, including COVID-19 clinical diagnosis, the analysis of epidemiological variables, and drug discovery by protein engineering techniques. Lastly, it explores the use of machine learning tools for investigating long COVID, by identifying patterns and relationships of symptoms, predicting risk indicators, and enabling early evaluation of COVID-19 sequelae.
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Affiliation(s)
| | - Jorge González-Puelma
- Centro Asistencial Docente y de Investigación, Universidad de Magallanes, Punta Arenas, Chile
- Escuela de Medicina, Universidad de Magallanes, Punta Arenas, Chile
| | - David Medina-Ortiz
- Departamento de Ingeniería en Computación, Facultad de Ingeniería, Universidad de Magallanes, Punta Arenas, Chile
| | - Jacqueline Aldridge
- Departamento de Ingeniería en Computación, Facultad de Ingeniería, Universidad de Magallanes, Punta Arenas, Chile
| | - Diego Alvarez-Saravia
- Centro Asistencial Docente y de Investigación, Universidad de Magallanes, Punta Arenas, Chile
- Escuela de Medicina, Universidad de Magallanes, Punta Arenas, Chile
| | - Roberto Uribe-Paredes
- Departamento de Ingeniería en Computación, Facultad de Ingeniería, Universidad de Magallanes, Punta Arenas, Chile
| | - Marcelo A. Navarrete
- Centro Asistencial Docente y de Investigación, Universidad de Magallanes, Punta Arenas, Chile
- Escuela de Medicina, Universidad de Magallanes, Punta Arenas, Chile
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3
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Su Y, Xing H, Shen W, Li M, Xu Y, Li Y. Fatal multisystem inflammatory syndrome in a 78-year-old adult after severe COVID-19 pneumonia during 2022 Omicron variant epidemic in Shanghai, China. J Infect Public Health 2023; 16:418-421. [PMID: 36731244 PMCID: PMC9832684 DOI: 10.1016/j.jiph.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/26/2022] [Accepted: 01/08/2023] [Indexed: 01/13/2023] Open
Abstract
Multisystem inflammatory syndrome adult type (MIS-A) is a rare type of post-acute COVID-19 syndrome which more frequently occurred in younger population. Here we present a 78-year-old Chinese female, the oldest case reported, diagnosed with MIS-A who had severe SARS-CoV-2 infection. She was diagnosed with severe COVID-19 and experienced an unexpected sudden hemodynamic collapse in the recovery period within three weeks. Her platelet count was sharply dropped, accompanied with sustained cardiac, kidney and liver injury. She was diagnosed with MIS-A according to criteria established by Center of Disease Control and Prevention. Though her condition was improved under administrating with high dose of methylprednisolone and intravenous immunoglobulin, methylprednisolone was unable to withdraw till two weeks as her partial pressure of oxygen/fraction of inspiration oxygen ratio and platelet count dropped on the heels of decreasing dosage. Unfortunately, the patient's condition gradually deteriorated with the development of severe nosocomial pneumonia. We presented this rare case in order to emphasize that MIS-A could occur in the elderly and the management of this population might be more difficult as the condition of the elderly with SARS-CoV-2 infection and MIS-A might be more severe.
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Affiliation(s)
- Yang Su
- Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China,Shanghai Public Health Clinical Center, Jinshan District, Shanghai, China
| | - Huan Xing
- Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China,Shanghai Public Health Clinical Center, Jinshan District, Shanghai, China
| | - Weijun Shen
- Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China,Shanghai Public Health Clinical Center, Jinshan District, Shanghai, China
| | - Ming Li
- Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China,Shanghai Public Health Clinical Center, Jinshan District, Shanghai, China
| | - Yawei Xu
- Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yingchuan Li
- Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China; Shanghai Public Health Clinical Center, Jinshan District, Shanghai, China.
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4
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Hoste L, Soriano-Arandes A, Buddingh EP, Whittaker E, Belot A, Ulloa-Gutierrez R, Olbrich P, Haerynck F. Severe Acute Respiratory Syndrome Coronavirus 2 Vaccination in Children with a History of Multisystem Inflammatory Syndrome in Children: An International Survey. J Pediatr 2022; 248:114-118. [PMID: 35598642 PMCID: PMC9119291 DOI: 10.1016/j.jpeds.2022.05.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/25/2022] [Accepted: 05/16/2022] [Indexed: 12/16/2022]
Abstract
The optimal severe acute respiratory syndrome coronavirus 2 vaccine strategy for patients with a history of multisystem inflammatory syndrome in children (MIS-C) is unclear. We performed an international survey (32 countries) and found substantial variations in vaccine policies. Respondents did not report relapses of MIS-C or other severe inflammatory side effects after severe acute respiratory syndrome coronavirus 2 vaccination in 273 patients with a history of MIS-C.
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Affiliation(s)
- Levi Hoste
- Primary Immune Deficiency Research Laboratory, Department of Internal Diseases and Pediatrics, Centre for Primary Immunodeficiency Ghent, Jeffrey Modell Diagnosis and Research Centre, Ghent University Hospital, Ghent, Belgium,Department of Internal Medicine and Pediatrics, Division of Pediatric Pulmonology, Infectious Diseases and Inborn Errors of Immunity, Ghent University Hospital, Ghent, Belgium
| | | | - Antoni Soriano-Arandes
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain
| | | | - Elizabeth Whittaker
- Paediatric Infectious Diseases, Imperial College Healthcare NHS Trust, London, United Kingdom,Section of Paediatric Infectious Diseases, Imperial College, London, United Kingdom
| | - Alexandre Belot
- Pediatric Nephrology Rheumatology and Dermatology, CHU Lyon, Lyon, France
| | - Rolando Ulloa-Gutierrez
- Servicio de Infectología Pediátrica, Hospital Nacional de Niños “Dr Carlos Sáenz Herrera”, Centro de Ciencias Médicas, Caja Costarricense de Seguro Social (C.C.S.S.), San José, Costa Rica
| | - Peter Olbrich
- Pediatric Infectious Diseases, Rheumatology and Immunology Unit, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla, IBiS/Universidad de Sevilla/CSIC, Red de Investigación Traslacional en Infectología Pediátrica RITIP, Sevilla, Spain,Departamento de Farmacología, Pediatría y Radiología, Facultad de Medicina, Universidad de Sevilla, Spain
| | - Filomeen Haerynck
- Primary Immune Deficiency Research Laboratory, Department of Internal Diseases and Pediatrics, Centre for Primary Immunodeficiency Ghent, Jeffrey Modell Diagnosis and Research Centre, Ghent University Hospital, Ghent, Belgium; Department of Internal Medicine and Pediatrics, Division of Pediatric Pulmonology, Infectious Diseases and Inborn Errors of Immunity, Ghent University Hospital, Ghent, Belgium.
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5
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Karatzios C, Scuccimarri R, Chédeville G, Basfar W, Bullard J, Stein DR. Multisystem Inflammatory Syndrome Following SARS-CoV-2 Vaccination in Two Children. Pediatrics 2022; 150:188099. [PMID: 35614536 DOI: 10.1542/peds.2021-055956] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/05/2022] [Indexed: 12/14/2022] Open
Abstract
This report presents 2 pediatric cases of multisystem inflammatory syndrome in children and adults (MIS-C/A) post severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination (MIS-V). Both children presented with MIS-V within 6 weeks of receiving their first and only dose of Pfizer-BioNTech's SARS-CoV-2 vaccine. The first patient had symptoms of MIS-C/A with peri-myocarditis and shock, and the second 1 had classic Kawasaki disease features. Both responded well to intravenous immunoglobulins and/or systemic corticosteroids. Both children were positive only for SARS-2-CoV antispike (S) (and not for antinucleocapsid [NC]) antibodies consistent with a postvaccine, and not a postinfection, event. Surveillance for rare adverse events following immunization should continue, especially now that SARS-CoV-2 vaccination is approved in the 5 to 11 year age group that has had the highest risk of developing MIS-C post SARS-CoV-2 infection. Our patients did not receive any further SARS-CoV-2 vaccines. Our report highlights the importance of measuring differentiating antibodies (anti-S and anti-NC) that can be used within a specific timeframe to help determine if a patient has MIS-V post vaccine (only anti-S present), or MIS-C/A post SARS-CoV-2 infection (both anti-S and anti-NC present).
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Affiliation(s)
- Christos Karatzios
- Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.,Divisions of Infectious Diseases
| | - Rosie Scuccimarri
- Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.,Rheumatology, Montreal Children's Hospital, Montreal, Quebec, Canada
| | - Gaëlle Chédeville
- Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.,Rheumatology, Montreal Children's Hospital, Montreal, Quebec, Canada
| | - Wijdan Basfar
- Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Jared Bullard
- Departments of Pediatrics and Child Health.,Medical Microbiology and Infectious Diseases, Cadham Provincial Laboratory, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Derek Riley Stein
- Medical Microbiology and Infectious Diseases, Cadham Provincial Laboratory, University of Manitoba, Winnipeg, Manitoba, Canada
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6
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Ko MS, Sullivan RP, Riskallah J, Weatherall CJ. Two cases of multisystem inflammatory syndrome in adults: experience at a single centre in Sydney. Intern Med J 2022; 52:1423-1428. [PMID: 35973957 DOI: 10.1111/imj.15875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 05/10/2022] [Indexed: 11/30/2022]
Abstract
We report two cases of middle-aged men who presented with clinical features that satisfied the diagnostic criteria for multisystem inflammatory syndrome in adults (MIS-A). Both patients were treated for toxic shock syndrome and MIS-A and have recovered. The purpose of this article is to communicate our experience and challenges of assessing and treating this condition and to raise awareness of the condition.
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Affiliation(s)
- Myung S Ko
- Department of Infectious Diseases, Immunology, and Sexual Health, St George Hospital, Sydney, Australia.,Department of Infectious Diseases, Prince of Wales Hospital, Sydney, Australia
| | - Richard P Sullivan
- Department of Infectious Diseases, Immunology, and Sexual Health, St George Hospital, Sydney, Australia.,St George and Sutherland Campus, School of Clinical Medicine, UNSW Medicine and Health, Sydney, Australia.,Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - John Riskallah
- Department of Cardiology, St George Hospital, Sydney, Australia
| | - Christopher J Weatherall
- Department of Infectious Diseases, Immunology, and Sexual Health, St George Hospital, Sydney, Australia.,St George and Sutherland Campus, School of Clinical Medicine, UNSW Medicine and Health, Sydney, Australia
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7
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Brown M, Garbajs NZ, Zec S, Mushtaq H, Khedr A, Jama AB, Rauf I, Mir M, Korsapati AR, Jain S, Koritala T, Adhikari R, Lal A, Gajic O, Domecq JP, Goksoy S, Bartlett B, Sharma A, Jain NK, Khan SA. A Case of Adult Multisystem Inflammatory Syndrome Following COVID-19 Vaccine. J Community Hosp Intern Med Perspect 2022; 12:7-13. [PMID: 36262897 PMCID: PMC9533789 DOI: 10.55729/2000-9666.1087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/12/2022] [Accepted: 04/19/2022] [Indexed: 01/09/2023] Open
Abstract
Multisystem inflammatory syndrome is a life-threatening condition associated with elevated inflammatory markers and multiple organ injury. A diagnosis of exclusion, it has been reported after severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2) in children and adults; recently it has been described in some post-COVID-19 vaccinated individuals. The prognosis with supportive care and immunomodulatory therapy is good, although some individuals may require treatment in the intensive care unit (ICU). Here we report a case of a 58-year-old man who developed multi-organ failure after receiving the second dose of the Moderna mRNA-1273 COVID-19 vaccine. He required critical organ support in the ICU. An extensive workup was done to rule out alternative infectious and inflammatory processes. Following a period of gradual in-hospital convalescence, our patient made a full recovery. To our knowledge, this is the first comprehensively described case of multisystem inflammatory syndrome associated with Moderna mRNA-1273 COVID-19 vaccine in an adult over 50 years of age.
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Affiliation(s)
| | | | | | | | | | | | | | - Mikael Mir
- University of Minnesota, Duluth, MN,
USA
| | | | - Shikha Jain
- MVJ Medical College and Research Hospital, Bengaluru,
India
| | | | | | | | | | | | | | | | - Amit Sharma
- Geisinger Community Medical Center, Scranton, PA,
USA
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8
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Rabaan AA, Bakhrebah MA, Mutair AA, Alhumaid S, Al-Jishi JM, AlSihati J, Albayat H, Alsheheri A, Aljeldah M, Garout M, Alfouzan WA, Alhashem YN, AlBahrani S, Alshamrani SA, Alotaibi S, AlRamadhan AA, Albasha HN, Hajissa K, Temsah MH. Systematic Review on Pathophysiological Complications in Severe COVID-19 among the Non-Vaccinated and Vaccinated Population. Vaccines (Basel) 2022; 10:985. [PMID: 35891149 PMCID: PMC9318201 DOI: 10.3390/vaccines10070985] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/13/2022] [Accepted: 06/17/2022] [Indexed: 02/06/2023] Open
Abstract
COVID-19, caused by SARS-CoV-2, is one of the longest viral pandemics in the history of mankind, which have caused millions of deaths globally and induced severe deformities in the survivals. For instance, fibrosis and cavities in the infected lungs of COVID-19 are some of the complications observed in infected patients post COVID-19 recovery. These health abnormalities, including is multiple organ failure-the most striking pathological features of COVID-19-have been linked with diverse distribution of ACE2 receptor. Additionally, several health complications reports were reported after administration of COVID-19 vaccines in healthy individuals, but clinical or molecular pathways causing such complications are not yet studied in detail. Thus, the present systematic review established the comparison of health complication noted in vaccinated and non-vaccinated individuals (COVID-19 infected patients) to identify the association between vaccination and the multiorgan failure based on the data obtained from case studies, research articles, clinical trials/Cohort based studies and review articles published between 2020-2022. This review also includes the biological rationale behind the COVID-19 infection and its subsequent symptoms and effects including multiorgan failure. In addition, multisystem inflammatory syndrome (MIS) has been informed in individuals post vaccination that resulted in multiorgan failure but, no direct correlation of vaccination with MIS has been established. Similarly, hemophagocytic lymphohistiocytosis (HLH) also noted to cause multiorgan failure in some individuals following full vaccination. Furthermore, severe complications were recorded in elderly patients (+40 years of age), indicates that older age individuals are higher risk by COVID-19 and post vaccination, but available literature is not sufficient to comply with any conclusive statements on relationship between vaccination and multiorgan failure.
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Affiliation(s)
- Ali A. Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
- Department of Public Health and Nutrition, The University of Haripur, Haripur 22610, Pakistan
| | - Muhammed A. Bakhrebah
- Life Science and Environment Research Institute, King Abdulaziz City for Science and Technology (KACST), Riyadh 11442, Saudi Arabia;
| | - Abbas Al Mutair
- Research Center, Almoosa Specialist Hospital, Al-Ahsa 36342, Saudi Arabia;
- College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia
- School of Nursing, Wollongong University, Wollongong, NSW 2522, Australia
- Nursing Department, Prince Sultan Military College of Health Sciences, Dhahran 33048, Saudi Arabia
| | - Saad Alhumaid
- Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia;
| | - Jumana M. Al-Jishi
- Internal Medicine Department, Qatif Central Hospital, Qatif 32654, Saudi Arabia;
| | - Jehad AlSihati
- Internal Medicine Department, Gastroenterology Section, King Fahad Specialist Hospital, Dammam 31311, Saudi Arabia;
| | - Hawra Albayat
- Infectious Disease Department, King Saud Medical City, Riyadh 7790, Saudi Arabia; (H.A.); (A.A.)
| | - Ahmed Alsheheri
- Infectious Disease Department, King Saud Medical City, Riyadh 7790, Saudi Arabia; (H.A.); (A.A.)
| | - Mohammed Aljeldah
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Hafr Al Batin, Hafr Al Batin 39524, Saudi Arabia;
| | - Mohammed Garout
- Department of Community Medicine and Health Care for Pilgrims, Faculty of Medicine, Umm Al-Qura University, Makkah 21955, Saudi Arabia;
| | - Wadha A. Alfouzan
- Department of Microbiology, Faculty of Medicine, Kuwait University, Safat 13110, Kuwait;
- Microbiology Unit, Department of Laboratories, Farwania Hospital, Farwania 85000, Kuwait
| | - Yousef N. Alhashem
- Department of Clinical Laboratory Sciences, Mohammed AlMana College of Health Sciences, Dammam 34222, Saudi Arabia;
| | - Salma AlBahrani
- Infectious Disease Unit, Specialty Internal Medicine, King Fahd Military Medical Complex, Dhahran 31932, Saudi Arabia;
| | - Saleh A. Alshamrani
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Najran University, Najran 61441, Saudi Arabia;
| | - Sultan Alotaibi
- Molecular Microbiology Department, King Fahad Medical City, Riyadh 11525, Saudi Arabia;
| | - Abdullah A. AlRamadhan
- Laboratory and Toxicology Department, Security Forces Specialized Comprehensive Clinics, Al-Ahsa 36441, Saudi Arabia;
| | - Hanadi N. Albasha
- Department of Infection Prevention and Control, Obeid Specialized Hospital, Riyadh 12627, Saudi Arabia;
| | - Khalid Hajissa
- Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia;
| | - Mohamad-Hani Temsah
- Pediatric Department, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia;
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9
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Sil A, Das A, Datta D. Mucocutaneous manifestations of COVID-19 related multisystem inflammatory syndrome in adults (MIS-A): an update. Clin Exp Dermatol 2022; 47:1774-1780. [PMID: 35603763 PMCID: PMC9348323 DOI: 10.1111/ced.15271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2022] [Indexed: 11/29/2022]
Abstract
Multisystem inflammatory syndrome in adults (MIS‐A) is an inflammatory condition that affects multiple extrapulmonary organ systems (cardiac, gastrointestinal tract, dermatological and/or neurological), attributed to a postinfectious and atypical complication occurring weeks to months after infection with severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2). The diagnosis is primarily based on findings encompassing persistent fever, elevated inflammatory markers, multiorgan involvement and a temporal relationship with COVID‐19 infection. The existing literature on MIS‐A, although growing, is limited to case reports and small case series. It is imperative that dermatologists be aware of this entity and aid the critical care team to ensure timely diagnosis and early therapeutic intervention. In this review, we concisely highlight the varied presentations, pathogenesis and treatment options in MIS‐A.
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Affiliation(s)
- Abheek Sil
- Department of Dermatology, Venereology, and Leprosy; RG Kar Medical College & Hospital, Kolkata, India
| | - Anupam Das
- Department of Dermatology, Venereology, and Leprosy; KPC Medical College & Hospital, Kolkata, India
| | - Debatri Datta
- Consultant Dermatologist, Oliva Skin and Hair Clinic, Kolkata, India
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10
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Li J, Sutton K, Ong L, Flower O, Gatward JJ, Jang H, Wood N, Hudson B, Tehrani S, Fernando SL. Recent SARS-CoV-2 infection: too early to vaccinate? Med J Aust 2022; 216:449-451. [PMID: 35462417 PMCID: PMC9115052 DOI: 10.5694/mja2.51499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 03/09/2022] [Accepted: 03/09/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Jamma Li
- Royal North Shore HospitalSydneyNSW
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11
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The Multifaceted Manifestations of Multisystem Inflammatory Syndrome during the SARS-CoV-2 Pandemic. Pathogens 2022; 11:pathogens11050556. [PMID: 35631077 PMCID: PMC9143280 DOI: 10.3390/pathogens11050556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/02/2022] [Accepted: 05/05/2022] [Indexed: 12/12/2022] Open
Abstract
The novel coronavirus SARS-CoV-2, which has similarities to the 2002–2003 severe acute respiratory syndrome coronavirus known as SARS-CoV-1, causes the infectious disease designated COVID-19 by the World Health Organization (Coronavirus Disease 2019). Although the first reports indicated that activity of the virus is centered in the lungs, it was soon acknowledged that SARS-CoV-2 causes a multisystem disease. Indeed, this new pathogen causes a variety of syndromes, including asymptomatic disease; mild disease; moderate disease; a severe form that requires hospitalization, intensive care, and mechanical ventilation; multisystem inflammatory disease; and a condition called long COVID or postacute sequelae of SARS-CoV-2 infection. Some of these syndromes resemble previously described disorders, including those with no confirmed etiology, such as Kawasaki disease. After recognition of a distinct multisystem inflammatory syndrome in children, followed by a similar syndrome in adults, various multisystem syndromes occurring during the pandemic associated or related to SARS-CoV-2 began to be identified. A typical pattern of cytokine and chemokine dysregulation occurs in these complex syndromes; however, the disorders have distinct immunological determinants that may help to differentiate them. This review discusses the origins of the different trajectories of the inflammatory syndromes related to SARS-CoV-2 infection.
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12
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Mizoguchi T, Yokoi M, Shintani Y, Yamamoto J, Mori K, Fujita H, Ito T, Sugiura T, Seo Y. A case of an elderly female who developed subacute pleuropericarditis following BNT162b2 mRNA COVID-19 vaccination. J Cardiol Cases 2022; 26:225-228. [PMID: 35600413 PMCID: PMC9110567 DOI: 10.1016/j.jccase.2022.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/09/2022] [Accepted: 04/30/2022] [Indexed: 11/29/2022] Open
Abstract
Despite the established safety of BNT162b2 coronavirus disease 2019 (COVID-19) vaccine, some rare but serious complications have been previously reported. Here, we report a rare case of an elderly female who developed subacute pleuropericarditis after the vaccination. An 88-year-old female experienced weight gain and dyspnea three days after the second dose of BNT162b2 vaccination, and one month later, presented to our hospital due to the exacerbation of the symptoms. Computed tomography showed remarkable pericardial and bilateral pleural effusions, and transthoracic echocardiogram visualized collapse signs of right and left atrium which indicates pre-tamponade. Percutaneous drainages of pericardial and pleural effusions stabilized her vital condition and revealed that all of them were exudative, indicating the presence of pleuropericarditis. Finally, we diagnosed this case as COVID-19 vaccine-associated pleuropericarditis because there were no signs of bacterial/viral infection or any other relevant causes except for the vaccination. When the pericardial and pleural effusions are concurrently found after COVID-19 vaccination, vaccine-associated pleuropericarditis should be considered as a differential diagnosis. The aggressive drainage of pericardial and pleural effusions could be helpful not only for diagnosis but also for treatment in the clinical management of COVID-19 vaccine-associated pleuropericarditis. Learning objective Although the safety and efficacy of BNT162b2 have been widely accepted, it is clinically important to know the potential risk of side effects. When the pericardial and pleural effusions are concurrently found after the vaccination, coronavirus disease 2019 vaccine-associated pleuropericarditis should be considered as a differential diagnosis.
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Affiliation(s)
| | - Masashi Yokoi
- Corresponding author at: Department of Cardiology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuhocho, Nagoya, Aichi 4678601, Japan.
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13
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Myocarditis following COVID-19 vaccination in adolescents and adults: a cumulative experience of 2021. Heart Fail Rev 2022; 27:2033-2043. [PMID: 35449353 PMCID: PMC9023259 DOI: 10.1007/s10741-022-10243-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/14/2022] [Indexed: 11/29/2022]
Abstract
Clinical course and outcomes of myocarditis after COVID-19 vaccination remain variable. We retrospectively collected data on patients > 12 years old from 01/01/2021 to 12/30/2021 who received COVID-19 messenger RNA (mRNA) vaccination and were diagnosed with myocarditis within 60 days of vaccination. Myocarditis cases were based on case definitions by authors. We report on 238 patients of whom most were male (n = 208; 87.1%). The mean age was 27.4 ± 16 (range 12–80) years. Females presented at older ages (41.3 ± 21.5 years) than men 25.7 ± 14 years (p = 0.001). In patients > 20 years of age, the mean duration from vaccination to symptoms was 4.8 days ± 5.5 days, but in < 20, it was 3.0 ± 3.3 days (p = 0.04). Myocarditis occurred most commonly after the Pfizer-BioNTech mRNA vaccine (n = 183; 76.45) and after the second dose (n = 182; 80%). Symptoms started 3.95 ± 4.5 days after vaccination. The commonest symptom was chest pain (n = 221; 93%). Patients were treated with non-steroidal anti-inflammatory drugs (n = 105; 58.3%), colchicine (n = 38; 21.1%), or glucocorticoids (n = 23; 12.7%). About 30% of the patients had left ventricular ejection fraction but more than half recovered the on repeat imaging. Abnormal cardiac MRIs were common; 168 patients (96% of 175 patients that had MRI) had late gadolinium enhancement, while 120 patients (68.5%) had myocardial edema. Heart failure guideline-directed medical therapy use was common (n = 27; 15%). Eleven patients had cardiogenic shock; and 4 patients required mechanical circulatory support. Five patients (1.7%) died; of these, 3 patients had endomyocardial biopsy/autopsy-confirmed myocarditis. Most cases of COVID-19 vaccine myocarditis are mild. Females presented at older ages than men and duration from vaccination to symptoms was longer in patients > 20 years. Cardiogenic shock requiring mechanical circulatory support was seen and mortality was low. Future studies are needed to better evaluate risk factors, and long-term outcomes of COVID-19 mRNA vaccine myocarditis.
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14
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Cole A, Thomas R, Goldman N, Howell K, Chakravarty K, Denton CP, Ong VH. Diffuse cutaneous systemic sclerosis following SARS-Co V-2 vaccination. J Autoimmun 2022; 128:102812. [PMID: 35247654 PMCID: PMC8888103 DOI: 10.1016/j.jaut.2022.102812] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 12/05/2022]
Abstract
The largest world-wide vaccination rollout ever is currently underway to tackle the covid-19 pandemic. We report a case of diffuse cutaneous systemic sclerosis (SSc) in a 70-year-old male with rapidly progressive skin thickening which developed two weeks after receiving the first dose of the ChAdOx1 nCOV-19 vaccine. As the onset of SSc skin was in close temporal proximity to the administration of the first dose vaccine with no other triggers, we suspected a possible adverse reaction to the ChAdOx1 nCOV-19 vaccine. We hypothesise that the recombinant adenoviral vector encoding the spike protein antigen of SARS-CoV-2 triggered an unexpected immune activation resulting in an atypical presentation of late-onset SSc, within the well-recognised ANA positive, ENA negative subgroup of patients.We review the possible mechanisms underlying autoimmunity when provoked by vaccination and other published rheumatological phenomenon occurring shortly after COVID vaccination.
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Affiliation(s)
- Alice Cole
- UCL Centre for Rheumatology and Connective Tissue Diseases, London, UK
| | - Rhys Thomas
- Royal Free London NHS Foundation Trust, London, UK
| | - Nina Goldman
- UCL Centre for Rheumatology and Connective Tissue Diseases, London, UK
| | - Kevin Howell
- Royal Free London NHS Foundation Trust, London, UK
| | | | | | - Voon H Ong
- UCL Centre for Rheumatology and Connective Tissue Diseases, London, UK.
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Abdelgalil AA, Saeedi FA. Multisystem Inflammatory Syndrome in a 12-Year-old Boy After mRNA-SARS-CoV-2 Vaccination. Pediatr Infect Dis J 2022; 41:e93-e94. [PMID: 34955518 PMCID: PMC8828311 DOI: 10.1097/inf.0000000000003442] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2021] [Indexed: 11/25/2022]
Abstract
Multisystem inflammatory syndrome in children (MIS-C) following SARS-CoV-2 infection is well known. We describe a 12-year-old child developing MIS-C after receiving 2 doses of mRNA COVID-19 vaccines without clinical evidence of COVID-19 infection. A possible association between the SARS-CoV-2 vaccine and MIS-C cannot be excluded.
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Affiliation(s)
| | - Fajr A Saeedi
- Department of Pediatrics, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
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Choi YK, Moon JY, Kim J, Yoo IS, Kwon GY, Bae H, Song MS, Kym S. Postvaccination Multisystem Inflammatory Syndrome in Adult with No Evidence of Prior SARS-CoV-2 Infection. Emerg Infect Dis 2021; 28:411-414. [PMID: 34852213 PMCID: PMC8798698 DOI: 10.3201/eid2802.211938] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Ten days after receiving the first dose of coronavirus disease vaccine, a 22-year-old woman in South Korea experienced myocarditis, myopathy, pericarditis, and gastroenteritis; rash subsequently developed. There was no evidence of prior infection with severe acute respiratory syndrome coronavirus 2. The diagnosis was multisystem inflammatory syndrome resulting from coronavirus disease vaccination.
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