An Intriguing Case of Multisystem Inflammatory Syndrome in an Adult Patient with Remote Infection with COVID-19 and Acute Chlamydia

Table 1

Lab values for the patient on the two emergency room (ER) visits and during hospitalization.

	Reference range	1^st ER visit	2^nd ER visit	72 hours after admission
WBC (10^3/µl)	4.5–10	11.5	13	23.1
Neutrophils (%)	34–72.6	79.7	92	90.8
Lymphocytes (%)	21.2–53.1	8.1	3.4	2.9
Monocytes (%)	4.7–12.5	11.2	2.8	1.2
Eosinophils (%)	0.8–7.0	0.1	1.0	3.1
Hemoglobin (g/dL)	12.2–16.2	14.2	15.7	12.6
Hematocrit (%)	36–51	41.9	46.8	36.7
Platelet (10^3/µl)	140–400	178	223	262
Sodium (mmol/L)	136–145	131	129	134
Potassium (mmol/L)	3.5–5.1	3.8	4.0	3.6
Carbon dioxide (mmol/L)	21–32	28	27	20
Blood urea nitrogen (mg/dL)	7–20	9	13	36
Creatinine (mg/dL)	0.44–1.27	1.25	1.77	2.96
Alanine aminotransferase (U/L)	13–61	36	97	71
Aspartate aminotransferase (U/L)	10–37	20	61	72
Alkaline phosphatase (U/L)	45–117	72	119	95
Total bilirubin (mg/dL)	0.2–1.0	0.7	0.9	0.8
Activated partial thromboplastin time (seconds)	25.3–37.0	—	32	43.5 (on iv heparin drip)
Prothrombin time (seconds)	9.4–12.5	—	19	13.1
INR	0.9–1.1	—	1.62	1.14
D-dimer (ng/mL)	0–500	—	3363	2350
Ferritin (ng/mL)	26–388	—	923.9	—
Lactate dehydrogenase (U/L)	87–241	—	265	—
ESR (mm/hr)	0–13	—	99	—
CRP (mg/dL)	0–0.3	—	32	—
NT-proBNP (pg/mL)	0–125	—	18953	>35000

WBC, white blood cell count; INR, international normalized ratio; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein; NT-proBNP, N-terminal-prohormone brain natriuretic peptide.