There have been reports of children presenting with severe inflammatory syndrome and laboratory-confirmed COVID-19 or an epidemiological link to a COVID-19 case in New York, the UK, Italy, and other countries.
The reports include illness with features of toxic shock syndrome and atypical Kawasaki disease. The clinical presentations vary, depending on the affected organ system involved (e.g., cardiac, gastrointestinal, renal, hematologic, dermatologic and neurologic). Features have included persistent fever, rash, abdominal pain, vomiting, or diarrhea, conjunctivitis, peripheral edema and extremity pain, hypotension, and signs of cardiac inflammation. Respiratory symptoms were not present in all cases. Inflammatory markers were elevated.
Many of these children tested negative for COVID-19 initially but on follow-up testing are positive for COVID-19, especially by serology.
≥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.