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Family Health

Parents' Next COVID-19 Fear: Multisystem Inflammatory Syndrome in Children

Published: May 29, 2020


What Is Multisystem Inflammatory Syndrome in Children (MIS-C)?

Even though the majority of children who contract COVID-19 have mild or no symptoms, a small number of children and adolescents have developed MIS-C. It’s currently suspected to be a postinfectious overreaction of the immune response to COVID-19, which is why we’re seeing it develop weeks after a patient was thought to have recovered from COVID-19. 

Young people with MIS-C have evidence of COVID-19 exposure, which can be determined through:

  • A positive antigen test, or a test that uses mucus from nasal and throat swabs to search for the virus’s genetic material
  • A positive antibody test, or a test that uses a blood sample to find proteins produced by the body in response to an infection
  • Known exposure to COVID-19 


What Does MIS-C Look Like? 

MIS-C has been compared to Kawasaki syndrome due to similarities such as inflammation, high fever, diffuse rash with swelling and eye redness, and heart complications. MIS-C also shares some of the symptoms of Toxic Shock Syndrome, such as low blood pressure, severe abdominal pain and confusion.

Children with MIS-C will appear ill and may exhibit the following symptoms:

  • High fever for at least 24 hours
  • Widespread rash
  • Eye redness
  • Swelling or peeling of the lips, hands and feet
  • Shock (low blood pressure and elevated heart rate), which can lead to listlessness, irritability, confusion, vomiting, abdominal pain, poor appetite and decreased urine output
  • Significantly elevated inflammatory markers

If your child has a combination of these symptoms and appears severely ill, seek immediate medical attention. MIS-C is alarming but treatable in most cases. Treatment often requires a multidisciplinary team of critical care physicians, cardiologists and infectious disease specialists.


How Can I Protect My Child?

The best way to protect children from MIS-C is to protect them from COVID-19. Just because children aren’t as likely to develop severe COVID-19 symptoms doesn’t mean they can’t contract the virus and spread it to other children and adults. 
Minimize your child’s risk through:

  • Social distancing. Avoid in-person playdates and large indoor events and gatherings. Pursue outdoor activities where you can practice social distancing. Keep video chatting with friends and family so your children don’t feel socially isolated.
  • Hand hygiene. Make it a routine, and teach children to wash their hands. Use the cinnamon test to show them how long it takes to properly wash hands.
  • Cloth masks. The American Academy of Pediatrics and the CDC are encouraging that children over the age of 2 wear cloth masks in public. Cloth masks for children under the age of 2 aren’t recommended due to the risk of suffocation.  

Does all that sound familiar? Hopefully these practices are now old hat. But as COVID-19 restrictions relax, it’s easy to forget that we still need to be alert


What Else Can I Do? 

Since MIS-C is new and our understanding is rapidly evolving, keep yourself educated. The CDC is a great resource for the latest MIS-C updates and has more information on cloth masks. Outside of taking COVID-19 precautions, the next best thing you can do for your child’s health is schedule their well-child checks and keep them on their immunization schedule.

COVID-19 and MIS-C should be taken seriously – both are life-threatening. But with social distancing, hand washing and masking, you can minimize the risk for your children, yourself and the community. 

More Resources

About the Author

Pediatrician Dr. Priscilla LaCroix loved every rotation in medical school but was certain she found her calling when she started her pediatric rotation.

“I always felt like the kids chose me,” she said. Dr. LaCroix has a special interest in community pediatrics.

“Community pediatrics is a privilege because you get the chance to build long-lasting relationships with your patients and their families,” she said. “It’s rewarding to watch children grow up and to have a positive role in their lives.”

See more articles from Priscilla LaCroix, DO, FAAP
Photo of Priscilla LaCroix, DO, FAAP