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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 about a possible connection between COVID-19 and a rare but serious health condition in children called multisystem inflammatory syndrome in children (MIS-C). Children with MIS-C usually develop the condition 2 to 6 weeks after being infected with COVID-19.

The link between COVID-19 and MIS-C is not yet fully 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.

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 (multisystem), such as the intestines, heart, lungs, skin and blood. While different, MIS-C has some of the same symptoms as other rare childhood conditions such as Kawasaki disease and toxic shock syndrome.

Contact your child's pediatrician right away if your child has a fever (100.4 degrees Fahrenheit or higher) lasting 24 hours or more and more than one of these symptoms:

  • stomach pain

  • bloodshot eyes

  • diarrhea

  • dizziness or lightheadedness

  • skin rash

  • vomiting

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. Notify the operator that you are seeking care for someone who has or may have COVID-19. Even if your child does not have a fever, you should seek immediate emergency medical care if your child:

  • is having trouble breathing or shortness of breath

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

  • starts to become confused

  • is unable to wake up or stay awake

  • has pale, gray or bluish-colored skin, lips or nail beds, depending on skin tone

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.

How is MIS-C diagnosed?

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

  • Blood tests

  • Chest x-ray

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

  • Abdominal ultrasound

Since MIS-C symptoms are similar to many other conditions, your doctor may also check for possible sources of illness such as:

Treatment for MIS-C

If your child is diagnosed with MIS-C, 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

If your child is hospitalized with MIS-C, the hospital team may arrange several follow-up appointments after your child has gone home. Children with MIS-C likely will need to see a pediatric cardiologist one to two 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 may also need to follow up with a pediatric rheumatologist.

If a child had MIS-C, do they need a COVID-19 vaccine?

Yes, all children who are eligible should receive a COVID-19 vaccine. COVID-19 vaccine should be delayed for at least 90 days after MIS-C was diagnosed and the doctor has made sure that your child is fully recovered.


The best way to prevent MIS-C is for all eligible children ages 6 months and up to get the COVID-19 vaccine. 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 at least a 3-foot distance between your unvaccinated child and people outside your household.

  • Wear face masks indoors in public in areas with high or substantial transmission, even if fully vaccinated.

  • Clean and disinfect "high touch" surfaces daily.


While MIS-C sounds frightening, keep in mind 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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