Patients with MIS-C have presented with a persistent fever, fatigue, and a variety of signs and symptoms including multiorgan (e.g., cardiac, gastrointestinal, renal, hematologic, dermatologic, neurologic) involvement, and elevated inflammatory markers.
Not all children will have the same signs and symptoms, and some children may have symptoms not listed here. A child under investigation for MIS-C should also be evaluated for other infectious (e.g. septic shock) and non-infectious (e.g., malignancy) etiologies that may explain the clinical presentation.
MIS-C may begin weeks after a child is infected with SARS-CoV-2. The child may have been infected from an asymptomatic contact and, in some cases, the child and their caregivers may not even know they had been infected.
Most children diagnosed with MIS-C have had laboratory evidence of either past or current COVID-19 infection and the majority have had no documented underlying medical conditions.
Information on laboratory evaluation, treatment, follow-up, and other clinical considerations for patients with suspected or diagnosed MIS-C have been provided by the CDC and a recently published guidance from the American College of Rheumatology which also compares and contrasts features of MIS-C and Kawasaki Disease as well as providing guidance evaluation and treatment.
≥38.0°C for ≥24 hours, or report of subjective fever lasting ≥24 hours
iiIncluding, but not limited to, one or more of the following: an elevated C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen, procalcitonin, d-dimer, ferritin, lactic acid dehydrogenase (LDH), or interleukin 6 (IL-6), elevated neutrophils, reduced lymphocytes and low albumin
Report cases that meet the CDC definition of Multisystem Inflammatory Syndrome in Children (MIS-C) by phone within 1 working day. Note patients should be reported regardless of SARS-CoV-2 PCT test result.