{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T16:14:25Z","timestamp":1762272865864,"version":"3.37.3"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T00:00:00Z","timestamp":1638835200000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Late complications and longer-lasting sequelae of COVID-19 infection in adults can occur. Cardiovascular involvement including reduced ejection fraction, coronary artery aneurysms, and pericardial involvement have been reported. Prompt recognition is the first step and secondly, these cardiovascular phenomena require an alternative set of therapeutics from the standard of care for acute COVID-19 infection.\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>Here we describe two cases that fulfill the current case definition of the recently defined multisystem inflammatory syndrome in adults (MIS-A). One patient is a 27-year-old white female and the other a 21-year-old French creole male, both without any prior medical history. Both were hospitalized and found to have significant cardiac dysfunction and treated with IVIG, high dose aspirin, and corticosteroids with resolution of their acute illnesses and cardiac sequelae.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Not only does the immediate impact of this viral infection need to be addressed, but also the long-term complications that could arise if not recognized and treated promptly as seen in our two cases. Patients can develop acute cardiovascular collapse and cardiogenic shock which requires high level of care and treatment within an intensive care unit. Depending on the complications, patients may require treatment for congestive heart failure, pericarditis, or even coronary artery disease acutely with close follow up to ensure improvement or resolution.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-021-06911-0","type":"journal-article","created":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T10:02:42Z","timestamp":1638871362000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Two cases of multi-inflammatory syndrome in children (MIS-C) in adults in 2020"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4046-3240","authenticated-orcid":false,"given":"Zachary","family":"Ciochetto","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter L.","family":"Havens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sol","family":"Aldrete","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,12,7]]},"reference":[{"key":"6911_CR1","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1056\/NEJMoa2021680","volume":"383","author":"LR Feldstein","year":"2020","unstructured":"Feldstein LR, et al. Multisystem inflammatory syndrome in U.S. Children and adolescents. N Engl J Med. 2020;383:334\u201346.","journal-title":"N Engl J Med"},{"key":"6911_CR2","doi-asserted-by":"crossref","unstructured":"Godfred-cato S et al. COVID-19\u2014associated multisystem inflammatory syndrome in children. MMWR. 2020.","DOI":"10.15585\/mmwr.mm6932e2"},{"key":"6911_CR3","doi-asserted-by":"publisher","DOI":"10.1002\/art.41454","author":"LA Henderson","year":"2020","unstructured":"Henderson LA, et al. American College of Rheumatology Clinical Guidance for Pediatric Patients with Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with SARS-CoV-2 and Hyperinflammation in COVID-19. Version 1. Arthritis Rheumatol. 2020. https:\/\/doi.org\/10.1002\/art.41454.","journal-title":"Arthritis Rheumatol"},{"key":"6911_CR4","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1001\/jama.2020.10369","volume":"324","author":"E Whittaker","year":"2020","unstructured":"Whittaker E, et al. Clinical characteristics of 58 children with a pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2. JAMA. 2020;324:259.","journal-title":"JAMA"},{"key":"6911_CR5","doi-asserted-by":"crossref","unstructured":"Morris SB et al. Case series of multisystem inflammatory syndrome in adults associated with SARS-CoV-2 infection\u2014United Kingdom and United States, 2020. MMWR Morb Mortal Wkly Rep. 2020.","DOI":"10.15585\/mmwr.mm6940e1"},{"key":"6911_CR6","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.120.317055","author":"A Akhmerov","year":"2020","unstructured":"Akhmerov A, Marb\u00e1n E. COVID-19 and the Heart. Circ Res. 2020. https:\/\/doi.org\/10.1161\/CIRCRESAHA.120.317055.","journal-title":"Circ Res"},{"key":"6911_CR7","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1001\/jamacardio.2020.1096","volume":"5","author":"RM Inciardi","year":"2020","unstructured":"Inciardi RM, et al. Cardiac involvement in a patient with coronavirus disease 2019 (COVID-19). JAMA Cardiol. 2020;5:819\u201324.","journal-title":"JAMA Cardiol"},{"key":"6911_CR8","first-page":"1","volume":"2019","author":"VO Puntmann","year":"2020","unstructured":"Puntmann VO, et al. Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered from coronavirus disease 2019 (COVID-19). JAMA Cardiol. 2020;2019:1\u20139.","journal-title":"JAMA Cardiol"},{"key":"6911_CR9","doi-asserted-by":"publisher","first-page":"618","DOI":"10.1111\/j.1365-2362.2009.02153.x","volume":"39","author":"GY Oudit","year":"2009","unstructured":"Oudit GY, et al. SARS-coronavirus modulation of myocardial ACE2 expression and inflammation in patients with SARS. Eur J Clin Invest. 2009;39:618\u201325.","journal-title":"Eur J Clin Invest"},{"key":"6911_CR10","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.1038\/s41591-020-0968-3","volume":"26","author":"A Gupta","year":"2020","unstructured":"Gupta A, et al. Extrapulmonary manifestations of COVID-19. Nat Med. 2020;26:1017\u201332.","journal-title":"Nat Med"},{"key":"6911_CR11","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.120.317015","author":"M Gheblawi","year":"2020","unstructured":"Gheblawi M, et al. Angiotensin-converting enzyme 2: SARS-CoV-2 receptor and regulator of the renin-angiotensin system: celebrating the 20th anniversary of the discovery of ACE2. Circ Res. 2020. https:\/\/doi.org\/10.1161\/CIRCRESAHA.120.317015.","journal-title":"Circ Res"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-021-06911-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-021-06911-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-021-06911-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T10:04:53Z","timestamp":1638871493000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-021-06911-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["6911"],"URL":"https:\/\/doi.org\/10.1186\/s12879-021-06911-0","relation":{},"ISSN":["1471-2334"],"issn-type":[{"type":"electronic","value":"1471-2334"}],"subject":[],"published":{"date-parts":[[2021,12]]},"assertion":[{"value":"24 March 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 November 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 December 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patients for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors report no competing interest relevant to this article.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1228"}}