Abstract
BACKGROUND Early in the COVID-19 pandemic, children who were infected with severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) with vascular inflammation were described as having a vasculitis similar to Kawasaki’s disease. There are now consensus clinical guidelines that have described the presentation and diagnosis of multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2 infection. This report aims to describe a case of MIS-C in an 11-year-old Saudi Arabian girl who presented with coronary artery aneurysm and cardiac involvement. CASE REPORT We describe an 11-year-old Saudi girl who was asymptomatic for 3 weeks after contracting SARS-CoV-2. Three weeks after suffering a mild flulike illness, she developed a high fever, cough, and severe clinical deterioration within 12 h of admission, including shock, rash, pleural effusion, high inflammatory markers, and a coronary aneurysm. As per current practice, the diagnosis was confirmed as multisystem inflammatory syndrome based on a SARS-CoV-2 test with reverse transcription polymerase chain reaction (RT-PCR) from 2 nasopharyngeal aspirates. Her condition was successfully treated with antibiotics, inotropes, IVIG, aspirin, and Tocilizumab, in addition to high-flow oxygen therapy. Eventually, she was able to return home after fully recovering. CONCLUSIONS The findings in this report suggest that children with MIS-C due to SARS-CoV-2 infection can have a good prognosis, even when they suffer from coronary artery and cardiac involvement. The increasing number of emerging SARS-CoV-2 variants that affect children supports the importance of RT-PCR for the COVID-19 diagnostic test for children with multisystem or cardiovascular inflammation, which may guide the most appropriate clinical management of the variants of MIS-C.
【초록키워드】 COVID-19, SARS-CoV-2, Inflammation, Prognosis, Tocilizumab, SARS-COV-2 infection, children, COVID-19 pandemic, diagnostic test, variant, SARS-CoV-2 variant, diagnostic, inflammatory markers, Diagnosis, oxygen, Antibiotics, cough, RT-PCR, variants, IVIG, MIS-C, reverse transcription polymerase chain reaction, polymerase chain reaction, Shock, Asymptomatic, SARS-CoV-2 variants, Fever, Oxygen therapy, Clinical management, Mild, Vasculitis, Aspirin, reverse transcription, disease, Admission, Rash, Inflammatory, Clinical deterioration, coronary aneurysm, Coronary artery, pleural effusion, Chain Reaction, high fever, Support, Aneurysm, Consensus, Inotropes, acute respiratory syndrome, nasopharyngeal aspirates, syndrome, SARS-CoV-2 test, vascular inflammation, high-flow oxygen therapy, Affect, clinical guideline, polymerase chain, described, were infected, addition, treated, children with MIS-C, 【제목키워드】 SARS-CoV-2, cardiac, girl, Artery, report, Coronary,