May 22, 2020, 11:13:19 AM CDT Oct 21, 2020, 3:36:34 PM CDT

What parents should know about multisystem inflammatory syndrome in children (MIS-C) and COVID-19

New concerns are being raised about an inflammatory condition in children that may be connected to coronavirus. Learn more.

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With the spread of coronavirus disease 2019 (COVID-19), researchers have been dedicated to learning more about how this new virus spreads, symptoms and possible ways to treat illness. Early data suggest that symptoms of COVID-19 are often respiratory and that children are not at increased risk for severe illness. However, new concerns are being raised about an unusual inflammatory response in children that may be related to coronavirus.

For many parents, any potential risk to children can feel alarming, but it's important to know that while there is still much unknown, this inflammatory disease seems to be rare and does not occur in most children with COVID-19. Learn more about this pediatric inflammatory syndrome possibly linked to COVID-19, including symptoms and ways to keep your child safe.

What is multisystem inflammatory syndrome in children with COVID-19?

As cases of COVID-19 spread around the world, health care providers noticed an increase in children with symptoms similar to Kawasaki disease, a condition most common in children under age 5 that causes inflammation in the blood vessels and can lead to heart damage. These symptoms occurred in children who tested positive for COVID-19. In the U.S., cases of this pediatric inflammatory syndrome were first reported in New York, but potential cases have now been reported in many states.

The Centers for Disease Control and Prevention (CDC) is calling this condition multisystem inflammatory syndrome in children (MIS-C). It was previously called pediatric multisystem inflammatory syndrome (PMIS). The CDC describes MIS-C as inflammation across multiple body systems, such as the:

  • Heart, lungs and kidneys
  • Brain
  • Skin
  • Eyes
  • Gastrointestinal organs

The CDC is working with partners to track cases of MIS-C and to learn more about its risk factors. More information is needed to confirm the relationship between this inflammatory condition and COVID-19 and why it affects certain children and not others.

"At this stage, this condition seems to be quite uncommon," explains Jeffrey Kahn, M.D., Director of Infectious Disease at Children's Health℠ and Professor at UT Southwestern. "The CDC has now created a case definition and issued a health advisory, so there should soon be data available that will help with our understanding of the impact of this disease in children. Further, as data become available, we may be able to define the relationship between COVID-19 and MIS-C. I encourage parents to rely on trusted sources of information as we learn more about this syndrome and to continue to take daily precautions to prevent the spread of COVID-19."

What are symptoms of multisystem inflammatory syndrome in children?

Father checking daughters tempSymptoms of MIS-C may vary in children, but can include:

  • Fever
  • Abdominal pain
  • Vomiting
  • Diarrhea
  • Neck pain
  • Rash
  • Bloodshot eyes
  • Feeling extra tired

It's important to know that presentation of these symptoms alone does not mean a child has MIS-C. The CDC defines MIS-C as an illness that includes fever and evidence of multi-organ inflammation. Doctors may need to perform tests to look for other signs of disease.

Preliminary data suggest that this inflammatory condition may be a late manifestation of infection in children – meaning it can develop weeks after a COVID-19 infection. However, children who develop symptoms of MIS-C may not have shown typical symptoms of COVID-19 infection, such as respiratory symptoms.

"Children are not presenting with typical features of COVID-19 but may instead present with persistent fever and at times greatly exaggerated features of inflammation," explains Dr. Kahn.

How can I protect my child against COVID-19 and MIS-C?

So far, cases of MIS-C are rare in children. Most children with COVID-19 infection develop only mild symptoms and appear to recover without complications. However, new information is being shared every day about the effects of this illness on children.

Parents should remain focused on encouraging their children to take steps to prevent the spread of COVID-19, such as:

In addition, if your child starts to show symptoms of MIS-C, contact your pediatrician. If your child shows warning signs such as trouble breathing, persistent pain or pressure in the chest, new confusion, inability to stay awake, bluish lips or face, or severe abdominal pain, seek emergency care right away.

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Children's Health is committed to remaining a trusted source of health information and care for you and your family during this time. See more resources to keep your family healthy at the Children's Health COVID-19 hub.

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