Multi System Inflammatory Syndrome In Neonates (MIS-N): A Case Report
DOI:
https://doi.org/10.46858/vimshsj.9306Keywords:
COVID-19, anti SARS-CoV-2 antibodies, multisystem inflammatory syndrome in children (MIS-C), neonateAbstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy may increase the risk of stillbirth, neonatal death, preterm birth, low birth weight, fetal distress, and neonatal asphyxia (1). Vertical transmission of SARS-CoV-2 is under investigation. A few reports suggest the possibility of SARS-CoV-2 transmission from mothers to their neonates. The SARS-CoV-2 virus was reported as one of the rare causes of fetal inflammatory response syndrome (FIRS) (5) and is associated with multisystem inflammatory syndrome in children (MIS-C) (6).Most neonates have mild symptoms, but some develop multisystem involvement including respiratory distress, feeding intolerance, lethargy. Most of the infants have elevated biomarkers, positive septic screen, and elevated inflammatory markers. Infants diagnosed with MIS-N gradually improve after 2 doses of IVIG and IV Steroid ( Methylprednisolone).
Downloads
References
Yang Z, Wang M, Zhu Z, Liu Y. Coronavirus disease 2019 (COVID-19) and pregnancy: a systematic review. The journal of maternal-fetal & neonatal medicine. 2020 Apr 30:1-4.
Kirtsman M, Diambomba Y, Poutanen SM, Malinowski AK, Vlachodimitropoulou E, Parks WT, Erdman L, Morris SK, Shah PS. Probable congenital SARS-CoV-2 infection in a neonate born to a woman with active SARS-CoV-2 infection. Cmaj. 2020 Jun 15;192(24):E647-50
Zeng L, Xia S, Yuan W, Yan K, Xiao F, Shao J, et al. Neonatal early-onset infection with SARS-CoV-2 in 33 neonates born to mothers with COVID-19 in Wuhan, China. JAMA Pediatr. (2020) 26:878. doi: 10.1001/jamapediatrics.2020.0878
Valdez LM, La Rosa M, Webb CM, Paredes T, Alzamora MC, Caceres D. Severe COVID-19 during pregnancy and possible vertical transmission..
Verdoni L, Mazza A, Gervasoni A, Martelli L, Ruggeri M, Ciuffreda M, Bonanomi E, D'Antiga L. An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. The Lancet. 2020 Jun 6;395(10239):1771-8.
Dufort EM, Koumans EH, Chow EJ, Rosenthal EM, Muse A, Rowlands J, Barranco MA, Maxted AM, Rosenberg ES, Easton D, Udo T. Multisystem inflammatory syndrome in children in New York State. New England Journal of Medicine. 2020 Jul 23;383(4):347-58.
Mehta NS, Mytton OT, Mullins EW, Fowler TA, Falconer CL, Murphy OB, Langenberg C, Jayatunga WJ, Eddy DH, Nguyen-Van-Tam JS. SARS-CoV-2 (COVID-19): what do we know about children? A systematic review. Clinical Infectious Diseases. 2020 Nov 1;71(9):2469-79.
Jones VG, Mills M, Suarez D, Hogan CA, Yeh D, Segal JB, Nguyen EL, Barsh GR, Maskatia S, Mathew R. COVID-19 and Kawasaki disease: novel virus and novel case. Hospital pediatrics. 2020 Jun;10(6):537-40.
Morand A, Urbina D, Fabre A. COVID-19 and Kawasaki like disease: the known-known, the unknown-known and the unknown-unknown. Preprints (Basel). 2020 May 9.
Royal College of Paediatrics and Child Health. Guidance: Paediatric multisystem inflammatory syndrome temporally associated with COVID-19. Londres (Royaume-Uni). 2020 May 1.
Varga Z, Flammer AJ, Steiger P, Haberecker M, Andermatt R, Zinkernagel AS, Mehra MR, Schuepbach RA, Ruschitzka F, Moch H. Endothelial cell infection and endotheliitis in COVID-19. The Lancet. 2020 May 2;395(10234):1417-8.
Jamilloux Y, Henry T, Belot A, Viel S, Fauter M, El Jammal T, Walzer T, François B, Sève P. Should we stimulate or suppress immune responses in COVID-19? Cytokine and anti-cytokine interventions. Autoimmunity reviews. 2020 Jul 1;19(7):102567.
Blumberg DA, Underwood MA, Hedriana HL, Lakshminrusimha S. Vertical transmission of SARS-CoV-2: what is the optimal definition?. American journal of perinatology. 2020 Jun;37(08):769-72.
Dong L, Tian J, He S, Zhu C, Wang J, Liu C, Yang J. Possible vertical transmission of SARS-CoV-2 from an infected mother to her newborn. Jama. 2020 May 12;323(18):1846-8.
Zeng H, Xu C, Fan J, Tang Y, Deng Q, Zhang W, Long X. Antibodies in infants born to mothers with COVID-19 pneumonia. Jama. 2020 May 12;323(18):1848-9.
Wang W, Xu Y, Gao R, Lu R, Han K, Wu G, Tan W. Detection of SARS-CoV-2 in different types of clinical specimens. Jama. 2020 May 12;323(18):1843-4.
Sharps MC, Hayes DJ, Lee S, Zou Z, Brady CA, Almoghrabi Y, Kerby A, Tamber KK, Jones CJ, Waldorf KM, Heazell AE. A structured review of placental morphology and histopathological lesions associated with SARS-CoV-2 infection. Placenta. 2020 Nov 1;101:13-29.
Wong YP, Khong TY, Tan GC. The effects of COVID-19 on placenta and pregnancy: what do we know so far?. Diagnostics. 2021 Jan;11(1):94.
Baergen RN, Heller DS. Placental pathology in Covid-19 positive mothers: preliminary findings. Pediatric and Developmental Pathology. 2020 Jun;23(3):177-80.
Shanes ED, Mithal LB, Otero S, Azad HA, Miller ES, Goldstein JA. Placental pathology in COVID-19. American journal of clinical pathology. 2020 Jun 8;154(1):23-32.
Ferraiolo A, Barra F, Kratochwila C, Paudice M, Vellone VG, Godano E, Varesano S, Noberasco G, Ferrero S, Arioni C. Report of positive placental swabs for SARS-CoV-2 in an asymptomatic pregnant woman with COVID-19. Medicina. 2020 Jun;56(6):306.
Patanè L, Morotti D, Giunta MR, Sigismondi C, Piccoli MG, Frigerio L, Mangili G, Arosio M, Cornolti G. Vertical transmission of coronavirus disease 2019: severe acute respiratory syndrome coronavirus 2 RNA on the fetal side of the placenta in pregnancies with coronavirus disease 2019–positive mothers and neonates at birth. American journal of obstetrics & gynecology MFM. 2020 Aug;2(3):100145.
Richtmann R, Torloni MR, Otani AR, Levi JE, Tobara MC, de Almeida Silva C, Dias L, Miglioli-Galvão L, Silva PM, Kondo MM. Fetal deaths in pregnancies with SARS-CoV-2 infection in Brazil: a case series. Case reports in women's health. 2020 Jul 1;27:e00243.
Gomez R, Romero R, Ghezzi F, Yoon BH, Mazor M, Berry SM. The fetal inflammatory response syndrome. American journal of obstetrics and gynecology. 1998 Jul 1;179(1):194-202.
Gotsch F, Romero R, Kusanovic JP, Mazaki-Tovi S, Pineles BL, Erez O, Espinoza J, Hassan SS. The fetal inflammatory response syndrome. Clinical obstetrics and gynecology. 2007 Sep 1;50(3):652-83.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Dr. Shreya Bhate, Dr. Mahesh Shinde, Dr. Ganesh Misal, Dr. Sunil Natha Mhaske
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.