Laboratory data for 60-year-old man with multisystem inflammatory syndrome after SARS-CoV-2 infection*
| Laboratory value | On admission | Day 1 after steroids | Day 2 after steroids, day 1 IVIG | Day 3 steroids, day 2 IVIG, discharge day | 6 wk after discharge | 12 wk after discharge | 16 wk after discharge | Reference range |
|---|---|---|---|---|---|---|---|---|
| Hematology and chemistry | ||||||||
| C-reactive protein (mg/L) | 274.7 | 71.6 | 35.1 | < 0.6 | < 0.6 | 1.5 | 0.0–8.0 | |
| Ferritin (ug/L) | 888 | 731 | 715 | 154 | 82 | 58 | 300–500 | |
| D dimer (mg/LFEU) | 2.14 | 1.07 | 1.01 | 0.81 | 0.61 | 0.58 | < 0.50 | |
| INR | 1.3 | 1.3 | 0.9–1.1 | |||||
| Leukocytes (109/L) | 16.2 | 15.0 | 18.6 | 8.0 | 4.1 | 4.3 | 4.1 | 4.0–11.0 |
| Neutrophils (109/L) | 14.0 | 13.3 | 16.7 | 6.2 | 1.9 | 2.0 | 2.0–8.0 | |
| Platelet count (109/L) | 248 | 375 | 505 | 464 | 202 | 218 | 179 | 150–400 |
| Lymphocytes (109/L) | 0.9 | 0.8 | 0.6 | 0.9 | 1.8 | 1.8 | 0.7–3.5 | |
| Hemoglobin (g/L) | 133 | 125 | 120 | 116 | 154 | 151 | 156 | 137–180 |
| Mean corpuscular vol. (fL) | 93 | 92 | 93 | 93 | 96 | 96 | 82–100 | |
| Triglycerides (mmol/L) | 2.11 | 1.65 | 1.50 | 1.67 | 0.00–1.70 | |||
| ALT (U/L) | 41 | 14 | 9 | 8 | 8–40 | |||
| Creatinine level (μmol/L) | 97 | 78 | 84 | 82 | 78 | 73 | 74 | 50–120 |
| Troponin (ng/L) | 38 | 0–13 | ||||||
| NT-pro BNT (ng/L) | 2840 | 70 | 63 | < 50 | 0–300 | |||
| Lactate (mmol/L) | 2.2 | 0.5–2.2 | ||||||
| Creatine kinase (U/L) | 29 | 0–195 | ||||||
| Lipase (U/L) | 17 | 0–80 | ||||||
| Lactate dehydrogenase (U/L) | 199 | 100–235 | ||||||
| Alkaline phosphatase (U/L) | 128 | 30–145 | ||||||
| Bilirubin total (μmol/L) | 15 | 0–24 | ||||||
| Glucose (random) (mmol/L) | 7.1 | 3.3–11.0 | ||||||
| Urine analysis | ||||||||
| Leukocytes | Trace | Negative | ||||||
| Nitrites | Negative | Negative | ||||||
| Protein | Negative | Negative | ||||||
| Glucose | Negative | Negative | ||||||
| Ketones | Negative | Negative | ||||||
| Blood | Trace | Negative | ||||||
| Leukocytes | 6–10 | 0–5/hpf | ||||||
| Epithelial cells | Moderate | /hpf¶ | ||||||
| Hyaline cast | 5–10 | /lpf¶ | ||||||
| Microbiology data | ||||||||
| Blood cultures | Negative × 2 | Negative | ||||||
| Urine culture | Negative | Negative | ||||||
| COVID-19 NAT† | Negative and positive** | Negative | Negative | |||||
| COVID-19 serology‡ | Positive | Negative | ||||||
| Respiratory infection panel§ | Negative | Negative | ||||||
| HIV serology | Negative | Negative | ||||||
| Hepatitis C antibody | Negative | Negative | ||||||
Note: ALT = alanine aminotransferase, FEU = fibrinogen-equivalent units, hpf = high power field, INR = international normalized ratio, IVIG = intravenous immunoglobulin, lpf = low power field, NAT = nucleic acid amplification, NT pro-BNP = N-terminal pro–brain-type natriuretic peptide.
↵* Bolded values show abnormal results.
↵† All COVID-19 NAT were on nasopharyngeal swabs.
↵‡ Immunoglobulin G serology testing.
↵§ Respiratory infection panel tests for influenza (A and B), parainfluenza virus (1, 2, 3, 4), human coronaviruses (229E, NL63, OC43, HKU1), metapneumovirus, enterovirus, rhinovirus and adenovirus.
↵¶ No reference range, as normally not seen.
↵** The patient had testing done as an outpatient on the day of admission (negative results) and then again when he went to the emergency department (positive results). For the positive nasopharyngeal swab, the cycle threshold value was 36 (very high), and insufficient for sequencing the spike protein and whole-genome sequencing. A higher cycle threshold value correlates with lower viral load1 and the repeat nasopharyngeal swab the next day came back negative. This likely suggests that the positive result was from residual RNA from the previous SARS-CoV-2 infection 4 weeks earlier, rather than reinfection or persistent infection.