We aimed to add to the descriptive data pertaining to the epidemiology, presentation and clinical course of Multisystem Inflammatory Syndrome (MIS) temporally associated with Coronavirus Disease 2019 in adults and adolescents from low- and middle-income countries.
We retrospectively reviewed patients presenting to the adult wards (14 years and older) of three academic hospitals in South Africa, diagnosed with MIS between 1 August 2020 and 31 May 2021. The presentation, laboratory and radiographic findings, and clinical course are described.
Eleven cases of MIS were reported, comprising of four adolescents (14-19 years) and seven adults (≥ 19 years). Fever was universal. Gastrointestinal symptoms (90.9%), cardiorespiratory abnormalities (90.9%) and mucocutaneous findings (72.7%) were prominent. Echocardiography in 10/11 (90.9%) showed a median left ventricular ejection fraction of 26.3% (interquartile range 21.9-33.6). All patients required high care admission and 72.7% required inotropic support. Glucocorticoids were initiated in all cases and 72.7% received intravenous immunoglobulin.
This constitutes the largest multicentre review of adults and adolescents with MIS in Africa. In resource-limited settings, MIS may be overlooked and heightened suspicion is needed in patients with multi-organ dysfunction, especially where repeated investigations for other aetiologies are negative.

Copyright © 2021. Published by Elsevier Ltd.