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COVID and Multisystem Inflammatory Syndrome in Children

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 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.

MIS-C can make children very ill. Thankfully, most children who have been diagnosed with MIS-C have recovered after getting medical care.

In 2023, there were at least 117 children with MIS-C . More than half of them did not have an underlying medical condition. Most of the children never received a COVID vaccine or had received their last dose at least 12 months before they were diagnosed with MIS-C.

Staying up to date with COVID vaccines protects against complications from COVID, including MIS-C.

Read on to learn more about symptoms and treatment of MIS-C.

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 you are concerned that your child is showing symptoms of MIS-C, including ongoing fever plus more than one of the following:

  • stomach pain

  • bloodshot eyes

  • diarrhea

  • dizziness or lightheadedness that are signs of low blood pressure

  • skin rash

  • vomiting

Your pediatrician can let you know if your child can be seen in the office.

Seek immediate emergency medical care if your child has any of the following:

  • Trouble breathing or shortness of breath

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

  • Starts to become confused

  • Unable to wake up or stay awake

  • 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 that you are seeking care for someone who has or may have recently had COVID.

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

  • 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:

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

  • Steroids to help treat swelling or inflammation

  • Heart medicines or low-dose aspirin

  • Fluids given through a vein

Children who become ill with MIS-C need to be treated in the hospital, according to the Centers for Disease Control and Prevention. 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 the recommended dose or doses of COVID vaccine. COVID 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 age 6 months and up to get the updated COVID vaccine. Keep taking steps to help avoid exposure to COVID and other respiratory viruses. 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.

  • Keep your child home and away from others when they are sick.

  • Wear face masks indoors in public when you or someone in your home were recently exposed to a respiratory virus, are sick or are recovering.

  • Clean and disinfect "high touch" surfaces.


While MIS-C sounds frightening, it is very rare. If your child has not received recommended immunizations, including the updated COVID vaccine, be sure to schedule their next well-child visit.

More information

Last Updated
American Academy of Pediatrics (Copyright @ 2024)
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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