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Multisystem Inflammatory Syndrome In Children (MIS-C)

MIS-C stands for Multisystem Inflammatory Syndrome in Children, a rare and serious inflammatory syndrome that affects children and young adults. It is associated with SARS-CoV-2, the virus that causes COVID-19 and usually occurs 2-6 weeks after infection with SARS-CoV-2.

It causes fever and inflammation and can affect different body parts, such as the heart, skin, eyes, and gastrointestinal organs. It can be very serious and children usually need to be treated in the hospital. However, almost all children get better with medical care.

MIS-C is very rare, and we do not know yet exactly what causes it. One possibility is that MIS-C is caused by an abnormal immune response to the SARS-CoV-2 virus, but we do not know yet why some children develop MIS-C after SARS-CoV-2 infection and some do not.

Signs & Symptoms

Because MIS-C can affect different body systems, there are many different symptoms that may occur.

The most commonly reported symptoms are:

• Fever

• Abdominal pain

• Vomiting

• Diarrhea

• Rash

• Bloodshot eyes

Patients with MIS-C have persistent fever, sometimes for 3 or 4 days. They may have dizziness or lightheadedness, which can be signs of low blood pressure. They may have excessive fatigue.

MIS-C shares some of the same features of Kawasaki’s disease, which usually affects children under 5 years of age and causes rashes, red eyes, and inflammation of the coronary arteries, along with swelling of the hands, feet and lymph nodes. It is not known whether these two conditions are related. Some findings in MIS-C are similar to a type of toxic shock syndrome seen with staph or strep bacteria.


There is no specific test to diagnosis MIS-C. The diagnosis is made using a combination of signs and symptoms along with blood tests. Some children need imaging tests such as echocardiograms (an ultrasound of the heart) to look for signs of inflammation. Many children with MIS-C test positive for SARS-CoV-2, the virus that causes COVID-19, with an antibody test and/or using a nasal swab, but not all.


Children usually need supportive care in the hospital for their symptoms, such as intravenous fluids or medicines that increase blood pressure. Doctors may use various medicines to reduce inflammation, which generally includes steroids, intravenous immunoglobulin (IVIG), or both.

Some children will need to be treated in the pediatric intensive care unit (PICU). However, most children with MIS-C recover quickly with treatment. Children generally follow-up with a specialist and have repeat blood tests or echocardiograms to monitor them after leaving the hospital. Most children have a full recovery.


The best way to prevent MIS-C is vaccination for COVID-19, including staying up-to-date with vaccine recommendations. Studies have shown that children who are vaccinated are much less likely to develop MIS-C. COVID-19 vaccination has also been associated with less severe illness with MIS-C, such as needing ICU-level care. COVID-19 vaccines can be given to a child with a history of MIS-C to protect them from getting COVID-19 again as long as they have fully recovered and it has been at least 90 days

since their MIS-C diagnosis. Parents should talk to their healthcare provider about COVID-19 vaccination in these situations. Further information is available at CDC:Clinical Considerations for Use of COVID-19 Vaccines: COVID-19 and MIS-C.

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© 2023 by Quality Life MN. Created by NdidiMarie Grafix for The Anika Foundation.


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