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What To Know About Multisystem Inflammatory Syndrome In Children

Medically reviewed by Karen Gill, M.D. — By Wendy Wisner on September 23, 2022Although COVID-19 is generally mild in children, some children do experience severe outcomes. One serious complication of COVID-19 in kids is multisystem inflammatory syndrome in children (MIS-C), an inflammatory syndrome that develops 2 weeks or more after becoming infected with SARS-CoV-2 (the virus that causes the disease COVID-19). The good news is that MIS-C is treatable, and kids usually make full recoveries. Still, MIS-C requires prompt medical care — sometimes emergency care. That’s why it’s important for parents and caretakers to be informed about what MIS-C looks like in kids, how to get a diagnosis, what to know about treatments, and how to prevent it.

What is multisystem inflammatory syndrome in children MIS-C

MIS-C is a constellation of inflammatory symptoms that can occur in children — including young children, teens, and young adults — within a few weeks after having COVID-19. MIS-C usually affects multiple organs in the body, including the skin (resulting in a rash), gastrointestinal system, heart, lungs, eyes, and brain.

How is multisystem inflammatory syndrome related to COVID-19

Children usually develop MIS-C about 2 to 6 weeks after a SARS-CoV-2 infection. That means that COVID-19 is the main contributing factor to the development of MIS-C. Children with MIS-C usually are either positive for SARS-CoV-2 upon examination or are positive for SARS-CoV-2 antibodies. Some parents are aware that their kids recently had COVID-19 or were exposed to it. Still, some children may not have had symptoms but show recent exposure through antibody testing. According to Centers for Disease Control and Prevention (CDC) data, 98% of children with MIS-C had a positive test result for SARS-CoV-2. The 2% who didn’t had previous close contact with someone with COVID-19.

What are the symptoms of multisystem inflammatory syndrome in children

Symptoms of MIS-C vary from one child to another, but MIS-C usually includes a fever for at least 24 hours, along with inflammatory symptoms in several body organs and organ systems. Symptoms of inflammation may be evident in your child’s:skinlungsdigestive systembrainkidneysheart These symptoms may look like this:a rash on their skinbloodshot eyesdiarrhea and/or vomitingtummy painfeeling dizzylethargy If you observe any of these symptoms, it’s important to call a pediatrician promptly. If you know that your child recently had COVID-19, make sure to share this information. Your child’s pediatrician will let you know what next steps to take.

When to seek emergency care if you have or have had COVID-19 — when it may be an MIS-C emergency

Anytime your child is showing symptoms of MIS-C, you should contact their pediatrician. However, there are some symptoms that require emergency medical care. If you notice any of these symptoms in your child, please call 911 or local emergency services or take them to the nearest emergency room:difficulty breathingchest pain or pressureseeming suddenly disorientedextreme lethargy, can’t be awokengray, blue, or pale skin, lips, or fingernails

What causes multisystem inflammatory syndrome in children

Experts aren’t sure exactly what causes MIS-C. One theory is that MIS-C is an overblown immune reaction to the SARS-CoV-2 virus. Anytime someone has a virus, their immune system reacts, but it may be that certain children have a more intense and delayed reaction to the virus, resulting in inflammation in multiple body systems. Whatever the exact cause, we know that MIS-C is related to a SARS-CoV-2 infection.

How is multisystem inflammatory syndrome diagnosed in children

If you notice any symptoms of MIS-C, you should contact a pediatrician right away. Only a medical doctor can diagnose your child with MIS-C. There are certain criteria a healthcare professional will use to formally diagnose your child with MIS-C. Your child might be diagnosed with MIS-C if they:are under 21 years oldhave a feverhave inflammation in multiple organsare currently positive for SARS-CoV-2, have SARS-CoV-2 antibodies, or know they were exposed to SARS-CoV-2 within the past 4 weeks Your child’s pediatrician may perform certain assessments or tests to diagnose your child with MIS-C. These may include:blood testsurine testsultrasound of your child’s abdomenX-rays of your child’s chestelectrocardiogram (EKG) or ultrasound of your child’s heart

How is multisystem inflammatory syndrome treated in children

The majority of children who have MIS-C will need to be treated in the hospital. Depending on how MIS-C is affecting your child, various treatment methods will be employed. These may include:steroids and other anti-inflammatory medicationsintravenous (IV) fluidsimmune system antibodies given via IVheart medication Even once your child is all better and out of the hospital, they’ll need to be monitored for a few months. For example, they may need to see a cardiologist to monitor how their heart is recovering after MIS-C. Children who were treated with steroids or immune system antibodies may also require medical follow-up.

Can you prevent multisystem inflammatory syndrome in children

Although rare, MIS-C is a serious condition and something to be avoided if possible. Besides minimizing your child’s chances of becoming infected with SARS-CoV-2 through practices such as handwashing, physical or social distancing, and mask wearing during times of high COVID-19 prevalence, the most effective way to protect your child against MIS-C is to get them vaccinated against SARS-CoV-2. Research has found that the COVID-19 vaccine for kids is protective against MIS-C, even if your child becomes infected with SARS-CoV-2. For example, research from the CDC found that two shots of Pfizer’s COVID-19 vaccine for kids ages 12 to 18 decreased the chances of getting MIS-C by 91%. Among teens who were critically ill with MIS-C, all were unvaccinated.

What are the risk factors for multisystem inflammatory syndrome in children

MIS-C can impact any child who was recently infected with SARS-CoV-2. However, certain individuals might be more likely to experience MIS-C than others. Risk factors that put children at greater risk of MIS-C include:being between the ages of 5 to 13being maleexperiencing obesityhaving asthmahaving any life-limiting underlying conditionbeing in a low-income family

MIS-C risk and race

U.S. data has found that Black and Hispanic children make up a disproportionate number of people with MIS-C. These populations also make up a disparate number of people with COVID-19 overall. Experts are still studying what factors put these children at higher risk, but one reason for these disparities may be inequities in healthcare faced by Black and Hispanic individuals.

What s the outlook for children who have multisystem inflammatory syndrome

According to the American Academy of Pediatrics (AAP), parents can be assured that MIS-C is rare and that the majority of children do well with supportive care. Still, recovery can be slow for some children, and some will continue to need care for a few months after leaving the hospital. If the walls of your child’s heart are inflamed (a condition called myocarditis), they may not be able to play sports or participate in other aerobic activities for a few months. As the CDC notes, the majority of children who had MIS-C are mostly symptom free by about 1 year past diagnosis. Still, children whose organs became inflamed during MIS-C may need about 6 months to recover. They also may experience symptoms such as exhaustion, anxiety, and neurological issues.

Frequently asked questions

Can my child get a COVID-19 vaccine after MIS-C

COVID-19 vaccines are one of the best ways to prevent severe SARS-CoV-2 infections and MIS-C. The AAP recommends waiting about 90 days after being diagnosed with MIS-C to get a COVID-19 vaccine.

How common is MIS-C among children

Thankfully, MIS-C is rare among children who contract SARS-CoV-2. CDC data shows that about 1 in every 3,000 children and 1 out of every 4,000 teens who get SARS-CoV-2 will develop MIS-C.

Is MIS-C ever deadly

MIS-C is rare to begin with, and most children recover with proper treatment. Tragically, though, MIS-C has been the cause of death in some children. According to CDC data as of August 2022, of the approximately 8,862 cases recorded of people with MIS-C, 72 children have died.

Takeaway

Learning about the seriousness of MIS-C can be distressing. Keep in mind that MIS-C is uncommon and that cases are usually treatable. You can protect your child from MIS-C by getting them vaccinated, learning about what symptoms look like, and being sure to get medical attention if you think your child may be experiencing MIS-C. Last medically reviewed on September 23, 2022

How we vetted this article

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.COVID-19 and multi-system inflammatory syndrome in children (MIS-C). (2021).
healthychildren.org/English/health-issues/conditions/COVID-19/Pages/covid_inflammatory_condition.aspxFor parents: Multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19. (2021).
cdc.gov/mis/mis-c.htmlHealth Department-reported cases of multisystem inflammatory syndrome in children (MIS-C) in the United States. (2022).
covid.cdc.gov/covid-data-tracker/#mis-national-surveillanceInformation for healthcare providers about multisystem inflammatory syndrome in children (MISC). (2021.)
cdc.gov/mis/mis-c/hcp/index.htmlMultisystem inflammatory syndrome in children (MIS-C). (2022).
coronavirus.health.ny.gov/multisystem-inflammatory-syndrome-children-mis-cMultisystem inflammatory syndrome in children (MIS-C): Frequently asked questions (2022).
cdph.ca.gov/Programs/OPA/CDPH%20Document%20Library/Toolkits/mis-c/misc-faq.pdfRhedin S, et al. (2022). Risk factors for multisystem inflammatory syndrome in children – A population-based cohort study of over 2 million children.
thelancet.com/journals/lanepe/article/PIIS2666-7762(22)00137-5/fulltextZambrano LD, et al. (2022). Effectiveness of BNT162b2 (Pfizer-BioNTech) mRNA vaccination against multisystem inflammatory syndrome in children among persons aged 12–18 years - United States, July–December 2021.
cdc.gov/mmwr/volumes/71/wr/mm7102e1.htmOur experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Current Version Sep 23, 2022 By Wendy Wisner Edited By Debbie Nurmi Medically Reviewed By Karen Richardson Gill, MD Copy Edited By Sarah Mills Share this articleMedically reviewed by Karen Gill, M.D. — By Wendy Wisner on September 23, 2022

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