Multisystem inflammatory syndrome

Rare Condition in People Who Recover From COVID-19 Can Be Difficult to Identify

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A rare and mysterious illness first reported in children who have recovered from COVID-19 is appearing in adults but can be hard to recognize.

The Centers for Disease Control and Prevention says multisystem inflammatory syndrome is similar to something first seen in kids and develops weeks after recovering from the coronavirus.

Tammy Holland thought she dodged a bullet when she got the coronavirus.

“I had mild symptoms with my COVID,” she said. “I had a stuffy nose, and that was it.” 

The 54-year-old mother of five is a breast cancer survivor and was worried about complications, so when the infection cleared, she was grateful.

But three weeks later she started feeling sick again.

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“They said I had pneumonia in my lower left lobe, so they gave me some medicine and sent me home,” she said. “Well, the next couple days, I started to get worse.”

Her family said they checked her into Anne Arundel Medical Center and she was put on a ventilator as doctors tried to pinpoint the problem.

Then her organs started failing and she was medevacked to the Hospital of the University of Pennsylvania for more sophisticated equipment to keep her alive.

Meanwhile, her family was searching for clues about her mysterious symptoms and found an article about multisystem inflammatory syndrome in children (MIS-C).

“And it was like ringing a bell, ringing a bell,” said Kathy Scarborough, Holland’s sister. “Like, wait a minute, all of these symptoms and this whole progression of symptoms is mirroring what was stated about these kids.”

The condition was first identified in the spring with kids developing a rash and inflammation around their heart and other organs several weeks after clearing their COVID infection.

Now the CDC confirms adults are now experiencing the same rare condition.

“So instead of just taking care of the virus, the immune system actually damages the organ systems in the body,” said Dr. Ermias Belay, an epidemiologist and medical officer with the CDC.

Multisystem inflammatory syndrome in adults (MIS-A) develops two-to-six weeks after someone is infected with the coronavirus, but adults don’t always have the telltale rash seen in children, which can make it difficult to recognize.

“There’s no specific laboratory test that would pick it up, but a patient who developed COVID-19, typically within days or weeks if they come back with the symptoms of fever and evidence of multiple organ failure symptoms, they should be considered potentially with having MIS-A and treated appropriately,” Belay said.

The CDC has identified fewer than 100 cases but admits that number is likely an underrepresentation because there’s no national surveillance system to track these types of cases.

Holland came close to death. At one point, her heart stopped beating.

“They shocked me 29 times … and they actually had called my family and told them that I had passed,” she said.

No one can explain what happened next. The family calls it divine intervention.

“They said that the nurse put a sponge in my mouth for oral care, and that I spit it out, and that my eyes opened up,” Holland said.

“That second visit is when we had the opportunity to, what I would say, witness a miracle, to see her open her eyes and to be able to communicate again with gesticulations, to be able to try to mouth something,” Scarborough said.

After that, Holland’s family says, she was treated with the recommended protocol for MIS-A, which includes an autoimmune treatment and steroids, and she started to improve. She's able to walk with a walker, now.

“She's getting stronger every day,” said LaShawnda Holland-Forrest, Holland’s daughter. “She has this fighting spirit, which I love.”

Holland is home and doing physical therapy to regain her strength after spending the past two months in hospitals.

The CDC said it’s getting the word out using standard communication channels to reach physicians and hospitals to alert them about MISA, how to diagnose it and how to treat it.

It’s too soon to know what puts someone at a higher risk for developing MIS-A.  

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