Is the fatality rate of MIS-A in adults 3 times that of children? Medical Alert: Seek medical attention immediately if these 2 signs appear
MIS-A cases will appear in 2-12 weeks after infection with multiple system inflammation
The number of confirmed cases in the country has exceeded 3 million. The outside world is not only worried that children will develop “multiple system inflammation” (MIS-C) after being infected with the epidemic, but will adult patients with multiple organ inflammation (MIS-A) also appear one after another? Li Jianzhang, chairman of the Taiwan Society of Pediatric Emergency Medicine and clinical professor of the Department of Emergency Medicine at National Taiwan University School of Medicine, issued an article pointing out that although the number of confirmed cases in Taiwan is declining day by day, cases of “adult multiple system inflammation” may occur 2 to 12 weeks after diagnosis, and Taiwan should see an increase in the number of cases. Related cases.
Professor Li Jianzhang said that the earliest case of MIS-C was in April 2020. Pediatricians in southeastern England discovered that 8 child patients had diseases similar to “Kawasaki syndrome” within 10 days. Two months later, similar illnesses were reported in 16 adults in the United Kingdom and the United States.
Among the similar characteristics of MIS-A in adults and MIS-C in children, the ethnic group is mostly African-Latino, usually obese, healthy in the past, mostly in young adults, and the clinical manifestations are high fever. One-third of patients with MIS-A will develop inflammation of the oral or eye mucosa, and the inflammation index in laboratory data will increase.
Is the fatality rate of MIS-A in adults 3 times that of children? Symptoms vary
Professor Li Jianzhang pointed out that adult MIS-A patients all have cardiac symptoms, including chest pain, arrhythmia, and heart failure. The biggest difference from severe COVID-19 is that respiratory symptoms in adults with MIS-A are mild or even absent. However, as case reports increase, it is found that about half of adult MIS-A patients need to be admitted to the intensive care unit, and the overall mortality rate is as high as 10%, which is much higher than the 1%-3% mortality rate in children.
“Everyone’s symptoms are diverse, bringing more confusion to doctors!” Professor Li Jianzhang said that the symptoms reported in these MIS-A cases range from neurological strokes and hallucinations to gastrointestinal abdominal pain, diarrhea, hepatitis, rash; The platelets during the examination are reduced or significantly increased, or even metabolic blood sugar is increased, ketoacidosis; lung shadows or water accumulation. Everyone has different combinations, and no fixed clinical criteria can be found to define the diagnosis.
Professor Li Jianzhang pointed out that the U.S. Centers for Disease Control and Prevention (CDC) has set a consistency standard for the consistency of public health surveys and to remind the public to pay attention to their symptoms. However, this diagnostic standard is as complex as the disease itself. For the general public, More difficult to understand clearly.
Information released by the CDC also stated that it is currently unclear how MIS-A occurs in adults after infection. It is recommended that if you have a persistent fever and experience one or more symptoms such as abdominal pain, bloodshot eyes, diarrhea, dizziness (low blood pressure), skin rash, and vomiting, you should seek medical advice as soon as possible. Seek treatment.
How is MIS-A diagnosed? Beware of red eyes and skin rashes
Professor Li Jianzhang suggested that the “123” rule can be used to summarize whether it is MIS-A. “1” refers to one prerequisite, which must be positive for either PCR, rapid screening or antibody after COVID-19 infection. “2” means that the two necessary conditions are fever (sudden death), plus evidence of inflammation in blood draw (blood indicators CRP, Ferritin, IL-6, PCT increased). “3” refers to damage to three organs that must include the heart or skin and mucous membranes. The most common ones are the heart, gastrointestinal, and neurological.
Professor Li Jianzhang reminded the public that there is a simpler way to be aware of MIS-A symptoms. As long as you have a sudden high fever but no obvious respiratory symptoms after being diagnosed with COVID-19, you should seek medical examination. Since less than half of the population will have red eyes or skin rash, these are very specific symptoms and are relatively easy to identify. It is recommended that family members and colleagues pay more attention to related symptoms.
Professor Li Jianzhang reminded that MIS-A has a certain fatal risk. Early medical treatment and early use of steroid or immunoglobulin therapy combined with anti-thrombosis are the only opportunities for treatment at present. The public should pay special attention to whether they have similar symptoms, and be sure to seek medical treatment as soon as possible when symptoms are discovered. .
source:
Professor Li Jianzhang “MIS-A Diagnosis 123”
Multisystem Inflammatory Syndrome in Adults (MIS-A)
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