Multisystem Inflammatory Syndrome in Children (MIS-C)

What is multisystem inflammatory syndrome in children (MIS-C)?

Multisystem inflammatory syndrome in children (MIS-C) is a rare condition that affects children who had COVID-19. It causes inflammation in several parts of your child’s body, including their:

• Heart.
• Lungs.
• Kidneys.
• Brain.
• Skin.
• Eyes.
• Organs within your child’s digestive tract (gastrointestinal).

It’s usually accompanied by a fever that lasts longer than 24 hours.

MIS-C can be very serious and life-threatening in rare cases. If your child shows symptoms, like difficulty breathing or severe chest pain, visit the emergency room immediately.

How common is multisystem inflammatory syndrome in children?

MIS-C is rare. It affects an estimated 1 out of every 3,000 to 4,000 children who had the COVID-19 virus.

What is the difference between MIS-C and MIS-A?

Both MIS-C and MIS-A refer to the same condition. The difference is the age of the person diagnosed. MIS-C affects children and young adults younger than 21 years old. MIS-A affects adults above age 21. MIS-C is more common than MIS-A, but MIS-A has more severe cases.

What are the symptoms of multisystem inflammatory syndrome in children?

Symptoms of MIS-C include having a fever for at least 24 hours and more than one of the following:

• Stomach or abdominal pain.
• Vomiting.
• Diarrhea.
• Lightheadedness or feeling dizzy.
• A skin rash.
• Bloodshot or red eyes.
• Loss of appetite.

Emergency signs of MIS-C

Visit the emergency room or call 911 immediately if your child shows any of the following signs:

• Difficulty breathing.
• Chest pain that doesn’t go away.
• Confusion.
• Severe stomach or abdominal pain.
• Trouble staying awake or not being able to wake up.
• Blue, gray or a pale tone to their skin, lips or fingernails.

What causes multisystem inflammatory syndrome in children?

The exact cause of MIS-C is unknown. Since the discovery of MIS-C in early 2020, research is ongoing to learn more about the cause and its long-term effects on children. The condition is a side effect of the COVID-19 infection, so your child is more at risk of developing MIS-C if they had COVID-19.

Studies suggest MIS-C could be the result of your child’s immune system overreacting after a COVID-19 infection. This could cause your child’s immune system to create inflammation that targets their organs.

There could also be genetic factors that make children more at risk of developing this condition.

Is multisystem inflammatory syndrome in children contagious?

No evidence suggests MIS-C is contagious. The COVID-19 virus that children catch before they develop MIS-C is highly contagious.

How is multisystem inflammatory syndrome in children diagnosed?

A healthcare provider will diagnose MIS-C in your child after a physical exam and testing. They’ll review your child’s symptoms and ask you questions about how long they’ve had a fever and if and when they tested positive for COVID-19. If your child actively has COVID-19, tell their care team immediately.

Testing can confirm a diagnosis and determine which of your child’s organs have symptoms. Testing could include the following imaging tests:

• Echocardiogram.
• Chest X-ray.
• Abdominal ultrasound.
• Computed tomography (CT) scan.

In addition, your child’s provider will likely test them for COVID-19 and offer additional laboratory tests depending on what symptoms your child has.

What’s a differential diagnosis for MIS-C?

Your child’s healthcare provider will make a list of possible conditions that could be the cause of their symptoms. This is called a differential diagnosis. Symptoms of MIS-C can look similar to the following conditions:

• Kawasaki disease.
• Toxic shock syndrome.

How is multisystem inflammatory syndrome in children treated?

Treatment for MIS-C may include:

• Receiving fluids from an IV (a needle placed into a vein in your child’s arm).
• Taking medications (oral or IV) to reduce inflammation (corticosteroids, immune globulin IVIG and glucocorticoids).
• Antiviral therapy (remdesivir) to treat COVID-19 if your child has an active infection.
• Receiving oxygen from an assisted breathing device (ventilator).

Treatment focuses on reducing inflammation and preventing possible life-threatening symptoms. If your child has MIS-C, they’ll receive treatment in a hospital or a pediatric intensive care unit (PICU) depending on how severe their symptoms are.

How soon after treatment will I feel better?

It could take between three days to two weeks before your child feels better after treatment. They’ll most likely be spending some time in a hospital care setting so a healthcare provider can monitor their condition.

Can multisystem inflammatory syndrome in children be prevented?

The best way to prevent MIS-C is to protect your child from a COVID-19 infection. You can keep your child safe by:

• Getting vaccinated for COVID-19 (including boosters if your child’s pediatrician recommends them).
• Teaching your child to wear a face mask that fits snugly around their mouth and nose.
• Avoid touching your eyes, nose and mouth to prevent the spread of germs.
• Teaching your child to wash their hands often with soap and water. They can also use an alcohol-based hand sanitizer (at least 60% alcohol) when they’re not near a sink.
• Avoiding close contact with people who have suspected or confirmed COVID-19.
• Socially distance yourself from others (at least 6 feet).
• Clean and sanitize frequently touched surfaces and objects.

What can I expect if my child has multisystem inflammatory syndrome?

Most children diagnosed with MIS-C make a complete recovery. It can be life-threatening and severe in rare cases. They’ll need treatment in a healthcare facility, most likely a hospital. Your child may need to see their primary care provider after they’ve completed treatment for MIS-C. Research is still ongoing to learn if there are any long-term side effects, so their provider will provide a physical exam to verify they’re in good health a few months following treatment.

How long does multisystem inflammatory syndrome in children last?

Your child may be ill with MIS-C for up to two weeks. This varies based on the severity of your child’s diagnosis. Treatment can improve your child’s outcome and recovery time.

When should I see a healthcare provider?

If your child has symptoms of MIS-C, even if they have no history of COVID-19 infection, contact your child’s healthcare provider. They’ll let you know whether you need to visit the emergency room and they can help you answer any questions you might have about the condition.

If your child has severe symptoms, visit the emergency room or call 911 immediately.

What questions should I ask my doctor?

• Does my child need to stay in the hospital?
• Are there symptoms that I should look out for?
• Are there side effects to the treatment?
• How do I make my child more comfortable when they have COVID-19?

A note from Cleveland Clinic

It can be scary to have to take your child to the hospital to receive treatment for MIS-C. Healthcare providers will treat and monitor your child around the clock to make sure their symptoms aren’t life-threatening. Some children may develop mild symptoms while others may have serious complications. Studies show that the majority of children make a full recovery. Research is ongoing to learn if children will have long-term effects from MIS-C and COVID-19. You can protect your child from developing MIS-C by getting them vaccinated and taking precautions around others like wearing a mask and washing their hands often.