Multisystem Inflammatory Syndrome in Adults (MIS-A) and SARS-CoV-2: An Evolving Relationship

Multisystem Inflammatory Syndrome in Adults (MIS-A) is a severe post-acute complication of SARS-CoV2 infection, occurring 4-6 weeks after infection and more common in young males, particularly of black (non-Hispanic) ethnicity. The prevalence ranges from 0.2% to 11.7% of SARS-CoV2 cases, with potential misdiagnoses. The pathophysiology is not fully understood, but may involve macrophage activation and antibody-dependent enhancement. MIS-A can also be associated with SARS-CoV2 vaccination, raising concerns about recurrence with future vaccinations. It affects individuals aged 21 and older, often leading to ICU admission due to cardiogenic shock, with a mortality rate of 5-7%. Treatment involves supportive care and immunosuppression, mainly using corticosteroids, but lacks a standardized approach. Further research is needed to understand MIS-A's prevalence, risk factors, and pathophysiology, and increased physician awareness and long-term follow-up are crucial for effective management.