ArticleFrontiers in cardiovascular medicine2026
Multisystem inflammatory syndrome in adults (MIS-A): cardiovascular manifestations and in-hospital outcomes from two tertiary centers.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Multisystem inflammatory syndrome in adults (MIS-A) is a rare, post-infectious hyperinflammatory condition characterized by multiorgan involvement and substantial cardiovascular morbidity. This study aimed to characterize the cardiovascular phenotype and clinical outcomes of adults with MIS-A and to compare findings between ICU and non-ICU patients. Methods: We conducted a multicenter retrospective case series of 22 hospitalized patients with a MIS-A phenotype across two university-affiliated clinical bases in Almaty, Kazakhstan (City Hospital No. 1 and City Hospital No. 7). Data were retrospectively abstracted from completed inpatient medical records after discharge or in-hospital death. Demographics, clinical manifestations documented during hospital days 0-3, baseline laboratory markers (first 24 h), treatments, and outcomes were extracted from medical records. Results: The median age was 43 years (IQR, 29-63; range 19-86), and 13/22 patients were female (59.1%). Fever (≥38 °C) was documented on 18/22 (81.8%). Mucocutaneous findings included rash in 12/22 (54.5%), enanthema in 10/22 (45.5%), and non-purulent conjunctivitis in 5/22 (22.7%). Echocardiography was available for 17/22 (77.3%); LVEF <50% was observed in 6/17 (35.3%). Gastrointestinal symptoms occurred in 7/22 (31.8%), neurologic manifestations in 8/22 (36.4%), and respiratory manifestations in 16/22 (72.7%). Inflammatory markers were markedly elevated, including C-reactive protein (median 181 mg/L, IQR, 95.4-245.0) and D-dimer (median 6.4 µg/mL FEU, IQR, 4.0-10.0). Leukocytosis occurred in 15/22 (68.2%), thrombocytopenia in 11/22 (50.0%), and lymphopenia in 8/22 (36.4%). Systemic corticosteroids were used on 14/22 (63.6%); ICU admission occurred on 11/22 (50.0%). In-hospital mortality was 5/22 (22.7%). Conclusion: Hospitalized patients with a MIS-A phenotype demonstrated severe hyperinflammation with frequent multiorgan involvement and meaningful in-hospital mortality. Early recognition and standardized assessment of organ dysfunction, particularly cardiovascular involvement, are essential.
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