Two cases of multisystem inflammatory syndrome in adults after improvement in severe acute respiratory distress syndrome due to coronavirus disease 2019

Abstract

Background Multisystem inflammatory syndrome in adults (MIS‐A) is a postacute coronavirus disease 2019 (COVID‐19) syndrome occurring weeks after severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection. Although this hyperinflammatory syndrome causes significant morbidity, mortality is low. Reports of MIS‐A following acute respiratory distress syndrome (ARDS) due to SARS‐CoV‐2 infection have rarely been reported. We describe two cases of MIS‐A that developed after recovery from critical acute COVID‐19. Case Presentation We present two cases of MIS‐A. In both cases, approximately 4 weeks after the onset of COVID‐19, the patients developed gastrointestinal disorders, complicated by other organ damage, and died. Conclusion ARDS and MIS‐A can occur in a patient with COVID‐19 at different times of onset. Clinicians should consider MIS‐A when unexplained multisystemic abnormalities are noted after the treatment of ARDS due to COVID‐19.

Keywords

• Acute respiratory distress syndrome
• coronavirus disease 2019
• extracorporeal membrane oxygenation
• gastrointestinal disturbance
• multisystem inflammatory syndrome in adults