COVID-19 and Multi-System Inflammatory Syndrome in Children

​You may have heard news reports about a possible connection between COVID-19 and a rare but serious health condition in children called multisystem inflammatory syndrome in children (MIS-C). Scientists from around the world, including pediatric specialists, are working together to understand MIS-C and how best to diagnose and treat it.

The link between COVID-19 and MIS-C is not well understood, and we are trying to learn if some children are more at risk. However, the American Academy of Pediatrics (AAP) wants to reassure parents that very few children get severely ill from the virus that causes COVID-19. So far, most children who have been diagnosed with MIS-C have recovered after getting medical care.

What we know

Children with MIS-C have a fever and inflammation in their body that gets confirmed from lab tests. While different, MIS-C has some of the same symptoms as other rare childhood conditions such as Kawasaki disease and toxic shock syndrome. Children with MIS-C may also have thrombosis (blood clots), poor heart function, or kidney injury.​

​Symptoms of MIS-C

Children with MIS-C are very ill with a fever for 24 hours or more, have inflammation in their bodies and problems with many organs, such as the intestines, heart, brain, lungs, skin, and kidneys. Contact your child's pediatrician right away if you notice any of these symptoms:

• fever (100.4 degrees Fahrenheit or higher) lasting 24 hours or more

• abdominal pain, diarrhea or vomiting

• neck pain

• rash or changes in skin color

• bloodshot eyes

• seems extra tired

• trouble breathing

• pain or pressure in the chest that doesn't go away

• becoming confused

• unable to wake up or stay awake

• bluish lips or face

Be sure to let your pediatrician or emergency care providers know if your child has tested positive for COVID-19 or has been exposed to someone with the virus within the past four weeks. Your pediatrician can let you know you if your child can be seen in the office, or if you need to go to the emergency department or call 911 right away.

Diagnosis and treatment

There are a few different tests doctors may use to help diagnose MIS-C, including:

• Blood tests

• Chest x-ray

• Heart ultrasound (echocardiogram)

• ​Abdominal ultrasound

In addition, medicines to treat the inflammation and fluids can help your child feel better. Children who become ill with MIS-C need to be treated in the hospital, according to the CDC. Some will need to receive care in the pediatric intensive care unit.

Children with MIS-C will need to see a pediatric cardiologist two or three weeks after leaving the hospital. MIS-C can cause the wall of the heart to be inflamed (myocarditis). Patients with myocarditis will be restricted from activities like exercise or sports for a period of time.

​Prevention

The best way to prevent MIS-C is to keep taking steps to help avoid exposure to COVID-19. For example, remember to:

• Wash hands often using soap and water for 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.

• Avoid people who are sick and keep a 6-foot distance between your child and people outside your household.

• Wear cloth face coverings.

• Clean and disinfect “high touch" surfaces daily.

• Wash laundry and plush toys as needed on the warmest setting advised and dry them fully.

Remember

While MIS-C sounds frightening, the AAP reminds parents that this condition is still very rare.

Call your pediatrician with any questions. Don't forget to make an appointment for well-child visits, too. All children should get recommended immunizations, including a flu shot, on time.

​More Information:

• 2019 Novel Coronavirus
• Can Children Get COVID-19?
• How is the flu different from COVID-19?
• Is it OK to call the pediatrician during COVID-19?
  
• Youth Sports Participation During COVID-19: A Safety Checklist​
  
• Mask Mythbusters: 5 Common Misconceptions about Kids & Cloth Face Coverings​