Evidence map›Paper›PMID 37484839›Full record

ArticleFrontiers in medicine2023

Clinical and biological heterogeneity of multisystem inflammatory syndrome in adults following SARS-CoV-2 infection: a case series.

Kaia E Barth, Natasha Spottiswoode, Charlotte Hurabielle, Lakshmi Subbaraj, COMET Consortium, Carolyn S Calfee, Michael A Matthay, Sarah French, Andrew Connolly, Stephen M Hewitt and 4 more

Open access · goldAbstract readCase Reports
In one paragraph

Article in Frontiers in medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 4 institutions in 1 country.

Kaia E BarthDepartment of Medicine, University of California, San Francisco, San Francisco, CA, United States.
Natasha SpottiswoodeDivision of Infectious Diseases, University of California, San Francisco, San Francisco, CA, United States.
Charlotte HurabielleDivision of Rheumatology, University of California, San Francisco, San Francisco, CA, United States.
Lakshmi SubbarajDepartment of Medicine, University of California, San Francisco, San Francisco, CA, United States.
COMET Consortium
Carolyn S CalfeeDivision of Pulmonary, Critical Care, Allergy, and Sleep Medicine, University of California, San Francisco, San Francisco, CA, United States.
Michael A MatthayDivision of Pulmonary, Critical Care, Allergy, and Sleep Medicine, University of California, San Francisco, San Francisco, CA, United States.
Sarah FrenchDivision of Rheumatology, University of California, San Francisco, San Francisco, CA, United States.
Andrew ConnollyDepartment of Pathology, University of California, San Francisco, San Francisco, CA, United States.
Stephen M HewittLaboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States.
Kevin M VannellaEmerging Pathogens Section, Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, United States.
Christopher BarnettDivision of Cardiology, University of California, San Francisco, San Francisco, CA, United States.
Charles R LangelierDivision of Infectious Diseases, University of California, San Francisco, San Francisco, CA, United States.
Sarah PattersonDepartment of Medicine, University of California, San Francisco, San Francisco, CA, United States.
University of California, San Francisco · USCenter for Cancer Research · USChan Zuckerberg Initiative (United States) · USNational Institute of Allergy and Infectious Diseases · US

Funding

BIOLOGY OF INFECTIOUS DISEASES TRAINING PROGRAMT32AI007641 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MATTHEW G DORSEY · 2000 to 2026
$6.9M
Precision Medicine in the Acute Respiratory Distress SyndromeR35HL140026 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CALFEE, CAROLYN · 2018 to 2024
$6.8M
Academic Rheumatology and Clinical ImmunologyT32AR079068 · NIAMS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Jinoos Yazdany, JULIE ZIKHERMAN · 2021 to 2026
$2.5M
NHLBI NIH HHS R35 HL140026NIAID NIH HHS T32 AI007641NIAMS NIH HHS T32 AR079068
6 · The paper itself

Abstract

Importance: Multisystem inflammatory syndrome in adults (MIS-A) is a poorly understood complication of SARS-CoV-2 infection with significant morbidity and mortality. Objective: Identify clinical, immunological, and histopathologic features of MIS-A to improve understanding of the pathophysiology and approach to treatment. Design: Three cases of MIS-A following SARS-CoV-2 infection were clinically identified between October 2021 - March 2022 using the U.S. Centers for Disease Control and Prevention diagnostic criteria. Clinical, laboratory, imaging, and tissue data were assessed. Findings: All three patients developed acute onset cardiogenic shock and demonstrated elevated inflammatory biomarkers at the time of hospital admission that resolved over time. One case co-occurred with new onset Type 1 diabetes and sepsis. Retrospective analysis of myocardial tissue from one case identified SARS-CoV-2 RNA. All three patients fully recovered with standard of care interventions plus immunomodulatory therapy that included intravenous immunoglobulin, corticosteroids, and in two cases, anakinra. Conclusion: MIS-A is a severe post-acute sequela of COVID-19 characterized by systemic elevation of inflammatory biomarkers. In this series of three cases, we find that although clinical courses and co-existent diseases vary, even severe presentations have potential for full recovery with prompt recognition and treatment. In addition to cardiogenic shock, glucose intolerance, unmasking of autoimmune disease, and sepsis can be features of MIS-A, and SARS-CoV-2 myocarditis can lead to a similar clinical syndrome.

Indexed as

COVID-19DKAMIS-Amultisystem inflammatory syndromemyocarditisSARS-CoV-2

Identifiers

PMID37484839
PMCPMC10357379
OpenAlexW4383374894

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.