Pediatr Infect Vaccine.  2022 Dec;29(3):155-160. 10.14776/piv.2022.29.e20.

Severe SARS-CoV-2 Infection With Multiorgan Involvement Followed by MIS-C in an Adolescent

Affiliations
  • 1Department of Pediatrics, Seoul National University Children’s Hospital, Seoul, the Republic of Korea
  • 2Department of Pediatrics, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, the Republic of Korea
  • 3Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, the Republic of Korea
  • 4Department of Pediatrics, Seoul National University College of Medicine, Seoul, the Republic of Korea

Abstract

Children and adolescents with coronavirus disease 2019 (COVID-19) generally have mild symptoms. Severe infection due to severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) involving multiorgan dysfunction is rare in this population. Herein, we present an unusual case of severe SARS-CoV-2 infection with multiorgan involvement followed by multisystem inflammatory syndrome in children (MIS-C) in a vaccinated 16-year-old boy. The patient was unconscious on initial presentation, and had severe paralytic ileus. On laboratory examination, there was severe metabolic acidosis, lymphocytopenia, thrombocytopenia, elevated inflammatory markers, elevated liver enzymes, and evidence of acute kidney injury with proteinuria and hematuria. His symptoms improved with the administration of remdesivir and dexamethasone. The patient briefly experienced MIS-C 2 weeks after the diagnosis of COVID-19, but the patient was discharged without any complications.

Keyword

COVID-19; MIS-C associated with COVID-19; SARS-CoV-2; Children
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