KEY CLINICAL MESSAGE
Clinicians should to be aware of Multisystem Inflammatory Syndrome in
Adult and Acute Limb Ischemia caused by COVID-19.
CASE DESCRIPTION
A 72-year-old man presented with a history of dyspnea and left lower
extremity pain for 1 week. Contrast-enhanced computed tomography scans
showed multiple arterial occlusions (Figure 1A, B) and no deep venous
thrombosis, bilateral lung diffuse consolidation (Figure 1C),
contrast-delayed areas in the myocardium (Figure 1D), and contrast
enhancement in the aortic walls (Figure 1E). The patient needed
noradrenaline. Laboratory examinations showed procalcitonin up to 40.60
ng/mL, C-reactive protein up to 31.57 mg/dL, creatinine kinase up to
13,861 U/L, D-dimer up to 258.8 µg/mL, high-sensitivity cardiac troponin
I up to 9.014 ng/mL, platelets down to 83000 /µL. Real-time polymerase
chain reaction via a nasopharyngeal swab was positive for COVID-19.
Above all, the patients met the criteria of Multisystem Inflammatory
Syndrome in Adults (MIS-A) Case Definition by Centers for Disease
Control and Prevention (1).
Despite we treated the patient with dexamethasone, the patient died on
the 17th day of hospitalization as a result of uncontrolled circulatory
failure and sepsis.
Acknowledgment: We thank Forte Science Communications, Inc.,
for proofreading the manuscript.
REFERENCE
Available fromhttps://www.cdc.gov/mis/mis-a/hcp.html
Author contributions:
Hiroshi Kobe: writing original draft
Akihiro Ito: writing review and editing
Tadashi Ishida: supervision, writing review and editing
INFORMED CONSENT
Informed consent was obtained.