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Volume 28, Number 7—July 2022
Dispatch

Multisystem Inflammatory Syndrome after Breakthrough SARS-CoV-2 Infection in 2 Immunized Adolescents, United States

Lyndsey D. Cole, Molly Slate, Samantha Minneman, and Michael J. BozzellaComments to Author 
Author affiliation: University of Colorado, Aurora, Colorado, USA

Main Article

Table 1

Laboratory results for 2 adolescent MIS-C case-patients, by day in hospital, United States*

Result† Case-patient 1, hospitalization for MIS-C
Case-patient 2‡
Pre–MIS-C hospitalization
Hospitalization for MIS-C
HD1 HD2 HD3 HD4 HD5 HD6 HD1 HD4 HD1 HD3 HD5 HD7 HD9
Leukocytes, × 109 cells/L
↓3.6
↓4.1
↓2.3
↓2.6
↓3.1
↓2.7

11.9
NA

7.8
5.8
↓2.9
5.4
9.0
Hemoglobin, g/dL
12.5
13.1
12.4
12.2
12.4
↓10.5

13.5
NA

13.8
↓10.8
↓10.4
↓10.3
↓10.5
Platelets, 109/L
↓98
↓109
188
237
321
362

290
NA

373
265
NA
305
331
Absolute neutrophil count, × 109 cells/L
2.4
3.3
↓1
↓0.9
↓1
↓0.6

NA
NA

↓1.4
1.8
2.0
3.6
4.7
Absolute lymphocyte count, × 109 cells/L
1
↓0.6
1.1
1.3
1.7
1.8

NA
NA

5.8
2.3
↓0.6
1.2
2.8
ESR, mm/h
NA
6
7
↑23
↑24
↑25

↑18
NA

↑22
↑96
NA
NA
NA
Sodium, mmol/L
↓130
↓136
↓134
↓133
↓132
137

↓135
NA

↓136
137
↓127
↓136
139
Creatinine, mg/dL
↑1.2
↑1.0
↑0.9
0.7
↑0.8
0.6

0.7
NA

↑1.0
↑2.2
↑3.9
↑2.3
↑1.3
AST, U/L
↑165
↑207
↑131
↑114
↑200
↑164

↑297
↑164

↑102
↑169
↑53
28
33
ALT, U/L
↑221
↑243
↑196
↑167
↑195
↑162

↑249
↑269

↑188
↑177
↑123
↑57
45
GGT, U/L
↑126
↑137
↑129
↑128
↑136
NA

NA
NA

↑342
↑209
NA
NA
NA
LDH, U/L
↑1,484
NA
↑1,155
↑928
↑863
NA

↑1,313
NA

↑982
NA
NA
NA
NA
C-reactive protein, mg/L
↑135
↑86
↑64
↑36
↑19
↑11

↑23
NA

↑17
↑47
↑56
↑19
10
Ferritin, ng/mL
↑750
NA
↑576
↑626
↑754
↑578

↑593
NA

191
284
NA
NA
NA
Albumin, g/dL
NA
↓2.9
↓2.8
↓2.8
↓3.1
↓3.1

↓3.1
↓3.2

3.6
↓2.6
3.0
↓3.1
↓3.1
aPTT, s
↑42.9
36.5
↑38.9
↑39.4
NA
NA

↓20.5
NA

28.9
31.3
NA
NA
NA
PT, s
14
12.6
13.5
13.7
14.1
13.5

13.4
NA

13.5
14.7
NA
NA
NA
Fibrinogen, mg/dL
328
354
302
269
317
NA

258
NA

413
NA
NA
NA
NA
D-dimer, μg/mL
NA
↑>4
↑>4
↑>4
↑3.1
NA

NA
NA

↑2.8
NA
NA
NA
NA
Troponin-I, ng/mL
0.03
↑0.04
↑0.05
0.03
0.02
NA

<0.02
NA

<0.02
NA
NA
NA
NA
NT-proBNP, pg/mL ↑365 ↑477 ↑601 ↑1,020 ↑212 NA 66 NA 85 ↑3,190 ↑3,360 ↑1,300 ↑1,590

*ALT, alanine aminotransferase; aPTT, activated partial thromboplastin time; AST, aspartate aminotransferase; ESR, erythrocyte sedimentation rate; GGT, gamma-glutamyl transpeptidase; HD, hospital day; LDH, lactate dehydrogenase; MIS-C, multisystem inflammatory syndrome in children; NT-proBNP, N-type pro-brain natriuretic peptide; PT, prothrombin time; ↑, increased outside of reference range; ↓, decreased outside of reference range. †Reference ranges: leukocytes, 5.2–9.7 × 109 cells/L; hemoglobin, 11.8–15.8 g/dL; platelets, 150–500 × 109/L; absolute neutrophil count, 1.8–6.6 × 109 cells/L; absolute lymphocyte count, 1.0–4.8 × 109/L; ESR, <15 mm/h; sodium, 137–145 mmol/L; creatinine, 0.2–0.7 mg/dL; AST, 15–40 U/L; ALT, <50 U/L; GGT, 10–28 U/L; LDH, 360–730 U/L; C-reactive protein, 0–10 mg/L; ferritin, 6–464 ng/mL; albumin 3.5–5 g/dL; aPTT, 23.5–37.5 s; PT, 11.5–15.0 s; fibrinogen, 200–450 mg/dL; D-dimer, <0.5 μg/mL; troponin-I, <0.03 ng/mL; NT-proBNP, <125 pg/mL ‡Omitted data for case-patient 2 from HD2 and HD3 of pre–MIS-C hospitalization and data from HD4, HD6, and HD8 of hospitalization for MIS-C were unnecessary for demonstrating clinical trends

Main Article

Page created: May 04, 2022
Page updated: June 18, 2022
Page reviewed: June 18, 2022
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