Multisystem Inflammatory Syndrome Following COVID-19: A Rare Presentation in Adults

Abstract

Background: A growing number of reports from around the world has described a severe inflammatory syndrome in
children similar to Kawasaki’s disease. This syndrome has been named multisystem inflammatory syndrome in children
(MIS-C). There have been anecdotal reports of MIS-C-like illness in young adults in their early twenties as well. We present
the case of a healthy 33-year-old woman who developed coronavirus disease 2019 (COVID-19) with clinical characteristics
resembling MIS-C, a rare form of COVID-19 described primarily in children under 21 years of age. Case presentation: The
patient presented with abdominal pain, loose motions, difficulty in breathing since 3 days and fever since 1 day. She was
otherwise healthy, with no prior medical history. Her hospital course was notable for leukocytosis, bradycardia, acute heart
failure (myocarditis) and pulmonary edema. MIS-C like illness secondary to COVID-19 was suspected due to presentation
of myocarditis, bradyarrhythmia and pulmonary edema. She improved after giving IV steroids, diuretics, anticoagulation
and supportive care and was discharged on hospital Day 5. Conclusion: MIS-C like illness should be considered in adults
presenting with atypical clinical findings and concern for COVID-19. Further research is needed to support the role of IVIG
and aspirin in this patient population.