Published: 2021-06-25

Post COVID-19 multisystem inflammatory syndrome in adults: a new clinical challenge

T. Suresh Babu, Sudhir Chandra Sinha, Siva Kumar Darimireddy, K. Kalyan Chakravarthy, Kotipalli Vidya Sagar


The spectrum of novel coronavirus disease (COVID-19) continues to evolve since its outbreak in November 2019. Although COVID-19 most commonly causes substantial respiratory pathology, it can also result in several extra pulmonary manifestations. Association between COVID-19 disease and a multisystem inflammatory syndrome in children (MIS-C) and adolescents has now been well defined. However, case reports describing a similar phenomenon in adults are sparse. We presented a case of 42 year old male who presented 3 weeks after initial COVID-19 infection with acute ST elevation myocardial infarction, splenic artery thrombosis, generalized anasarca, with hepatic and renal dysfunction, but minimal respiratory symptoms. He had a turbulent hospital course. However timely suspicion of presence of multisystem inflammatory syndrome in adult (MIS-A) and use of hemoadsorption filters helped to save his life.


COVID-19, Multisystem inflammatory syndrome-adults, HA 330 filters

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Riphagen S, Gomez X, Gonzalez-Martinez C, Wilkinson N, Theocharis P. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet. 2020;395(10237):1607-8.

Jiang L, Tang K, Levin M, Irfan O, Morris SK, Wilson K, et al. COVID-19 and multisystem inflammatory syndrome in children and adolescents. Lancet Infect Dis. 2020;20(11):276-88.

Centers for Disease Control and Prevention. Fact sheet: Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with Coronavirus Disease 2019 (COVID-19). Available at: Accessed on 15 May 2021.

WHO. Fact sheet: Multisystem inflammatory syndrome in children and adolescents with COVID-19, 2020. Available at: Accessed on 15 May 2021.

Morris SB, Schwartz NG, Patel P, Abbo L, Beauchamps L, Balan S, et al. Case series of multisystem inflammatory syndrome in adults associated with SARS-CoV-2 Infection-United Kingdom and United States, March-August 2020. MMWR Morb Mortal Wkly Rep. 2020;69(40):1450-6.

Kornitzky FW, Langen HJ, Held M. Treatment of a Patient with a Pronounced Cytokine Storm in Severe COVID-19 Pneumonia using a Hemoadsorption in Combination with the Administration of tocilizumab. Pneumologie. 2021.

Rizvi S, Danic M, Silver M, LaBond V. Cytosorb filter: an adjunct for survival in the COVID-19 patient in cytokine storm? a case report. Heart Lung. 2021;50(1):44-50.