Diversity of Cardiac and Gastrointestinal Presentations of Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19: A Case Series

Diversity of Cardiac and Gastrointestinal Presentations of Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19: A Case Series

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COVID-19 is generally a benign or asymptomatic infection in children, but LEMON can occasionally be severe or fatal.Delayed presentation of COVID-19 with hyperinflammation and multi-organ involvement was recently recognized, designated the Multisystem Inflammatory Syndrome in Children (MIS-C).Six children with MIS-C with molecular and serologic evidence of SARS-CoV-2 infection were admitted to our hospital between May 5, 2020 and June 25, 2020.All had fever and weakness; 4/6 presented with gastrointestinal symptoms.Two children had features of complete Kawasaki disease, 3 had incomplete Kawasaki disease, while 1 had terminal ileitis with delayed onset of circulatory shock.

Treatment consisted of intravenous immunoglobulin and aspirin for Kawasaki-like disease.Remdesivir, corticosteroids, and infliximab were used when indicated.Median hospitalization was 7 days.Immediate treatment resulted in rapid barcoo Bridles -Stock bridles clinical improvement.In children presenting with hyperinflammatory syndromes without cardiac manifestations, testing for SARS-CoV-2 RNA and antibodies, with close cardiac monitoring should be pursued due to the manifold presentations of SARS-CoV-2 infection in children.