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COVID-19 and Multi-System Inflammatory Syndrome in Children (MIS-C)

COVID-19 and Multi-System Inflammatory Syndrome in Children 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.

The best thing you can do to protect your child is to call your pediatrician if you have any concerns about your child's health.

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

  • shortness of breath

  • 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 and urine tests

  • Chest x-ray

  • ​Electrocardiogram, which measures electrical activity in the heart, and echocardiogram (heart ultrasound)

Depending on your child's symptoms and test results, treatment may include:

  • steroids to help treat swelling or inflammation

  • Intravenous immune globulin (IVIG), a “biologic" medicine that contains immune-system antibodies

  • Fluids given through a vein

  • Heart medicines or low-dose aspirin

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.

Follow-up care

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. Children treated with steroids or a biologic medicine should also follow up with a pediatric rheumatologist.


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.

  • Clean and disinfect “high touch" surfaces daily.

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


While MIS-C sounds frightening, remember 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:

Last Updated
American Academy of Pediatrics (Copyright © 2020)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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