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Kawasaki-like multisystem inflammatory syndrome associated with SARS-CoV-2 infection in an adult
  1. Eamonn Faller1,
  2. Rachel Barry2,
  3. Owen O'Flynn3,
  4. Peter Kearney4 and
  5. Corinna Sadlier1,5
  1. 1Department of Infectious Diseases, Cork University Hospital Group, Cork, Ireland
  2. 2Microbiology, Cork University Hospital, Cork, Ireland
  3. 3Department of Medicine, Cork University Hospital, Wilton, Cork
  4. 4Cardiology, Cork University Hospital Group, Cork, Ireland
  5. 5School of medicine, University College Cork, Cork, Ireland
  1. Correspondence to Dr Corinna Sadlier; Corinna.Sadlier{at}hse.ie

Abstract

Kawasaki-like hyperinflammatory syndrome has been widely described as a manifestation of SARS-CoV-2 infection in paediatric patients. We report a compatible presentation and suggest that physicians consider the potential for this multisystem inflammatory syndrome to occur in adults. A 23-year-old man presented to hospital with a 4-day history of vomiting, diarrhoea, dry cough, fever and a blanching erythematous rash on hands, feet and buttocks. He was otherwise fit and healthy. On day 3 of admission, marked bilateral conjunctivitis developed and high sensitivity troponin I increased significantly, followed by acute respiratory compromise requiring high-flow nasal oxygen therapy. Transthoracic echocardiogram on day 5 showed severe global hypokinesis of the left ventricle with an ejection fraction of 22%. SARS-CoV-2 was not detected by reverse transcription PCR on nasopharyngeal swabs, sputum or stool samples, however, SARS-CoV-2 antibody was positive. The patient’s syndrome resolved and cardiomyopathy reversed completely with supportive measures. He has since made a good recovery.

  • COVID-19
  • infectious diseases
  • cardiovascular medicine

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Footnotes

  • Twitter @eamofaller

  • Contributors EF—drafted main article, drafted table. OO’F—provided clinical images, drafted paragraphs, edited, signed off. RB—edited and clarified areas relating to microbiology, finalised. PK—clarified and edited areas relating to cardiology, Finalised/signed off. CS—edited, signed off, clarified in areas relating to infectious disease.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.