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Characteristics Associated With Multisystem Inflammatory Syndrome Among Adults With SARS-CoV-2 Infection

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

A postacute COVID-19 multisystem inflammatory syndrome (MIS) has been recognized as a rare, yet severe, complication of SARS-CoV-2 infection. First characterized in children,1,2 MIS in adults (MIS-A) has now been reported,3 leading to the publication of a working case definition by the Centers for Disease Control and Prevention.4

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Article Information

Accepted for Publication: March 24, 2021.

Published: May 19, 2021. doi:10.1001/jamanetworkopen.2021.10323

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Davogustto GE et al. JAMA Network Open.

Corresponding Author: Giovanni E. Davogustto, MD, Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, 2220 Pierce Ave, 383 Preston Research Bldg, Nashville, TN 37232-6300 (giovanni.e.davogustto@vumc.org).

Author Contributions: Dr Davogustto had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Davogustto, Clark, Hardison, Halasa, Wells.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Davogustto, Clark, Hardison.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Davogustto.

Administrative, technical, or material support: Davogustto, Clark, Hardison, Yanis, Lowery.

Supervision: Wells.

Conflict of Interest Disclosures: Dr Halasa reported receiving grants from Sanofi and Quidel outside the submitted work. No other disclosures were reported.

Funding/Support: Vanderbilt University’s Research Derivative and Research Electronic Data Capture (REDCap) resources are supported by Clinical and Translational Science Award UL1 TR002243 from the National Center for Advancing Translational Sciences. Research reported in this article was supported in part by award T32HL007411 from the National Heart, Lung, and Blood Institute of the National Institutes of Health (Dr Clark).

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Disclaimer: The content and views expressed in this article are those of the authors and do not necessarily represent official views of the National Center for Advancing Translational Sciences or the National Institutes of Health.

Additional Contributions: We thank Josh F. Peterson, MD, MPH, Lisa Bastarache, MS, and others in the Department of Biomedical Informatics of Vanderbilt University Medical Center (VUMC) for stimulating discussions on the initial design of the study and for creating and making readily available a COVID-19 data registry from electronic health records into VUMC’s Research Derivative. We also thank Dan M. Roden, MD (VUMC), for stimulating discussions on study design and his critical review of the manuscript. None of these individuals were compensated for their contributions.

References
1.
Feldstein  LR , Rose  EB , Horwitz  SM ,  et al; Overcoming COVID-19 Investigators; CDC COVID-19 Response Team.  Multisystem inflammatory syndrome in U.S. children and adolescents.   N Engl J Med. 2020;383(4):334-346. doi:10.1056/NEJMoa2021680 PubMedGoogle ScholarCrossref
2.
Dufort  EM , Koumans  EH , Chow  EJ ,  et al; New York State and Centers for Disease Control and Prevention Multisystem Inflammatory Syndrome in Children Investigation Team.  Multisystem inflammatory syndrome in children in New York State.   N Engl J Med. 2020;383(4):347-358. doi:10.1056/NEJMoa2021756 PubMedGoogle ScholarCrossref
3.
Chau  VQ , Giustino  G , Mahmood  K ,  et al.  Cardiogenic shock and hyperinflammatory syndrome in young males with COVID-10.   Circ Heart Fail. 2020;13(10):e007485. doi:10.1161/CIRCHEARTFAILURE.120.007485PubMedGoogle Scholar
4.
Morris  SB , Schwartz  NG , Patel  P ,  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):1450-1456. doi:10.15585/mmwr.mm6940e1 PubMedGoogle ScholarCrossref
5.
Danciu  I , Cowan  JD , Basford  M ,  et al.  Secondary use of clinical data: the Vanderbilt approach.   J Biomed Inform. 2014;52:28-35. doi:10.1016/j.jbi.2014.02.003 PubMedGoogle ScholarCrossref
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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