Multisystem Inflammatory Syndrome in children (MISC-C) and COVID-19: What providers should know

While the majority of cases of COVID-19 in children result in no symptoms or mild symptoms, some hospitals have recently reported an increased  number of cases of children with a multisystemic inflammatory syndrome that shares many characteristics with Kawasaki disease, an inflammatory disease of childhood that can affect blood vessels. Once referred to as PIMS, this new syndrome has been named multisystem inflammatory syndrome in children, or MIS-C by the Centers for Disease Control.

While research on the apparent link between COVID-19 and MIS-C is limited, scientists around the country are working to learn more about the correlation. In this Q & A,  Dr. Negar Ashouri, pediatric infectious disease specialist at CHOC Children’s, shares information about MIS-C .

What is MISC-C?

MIS-C is a condition where different body parts – such as the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs – become inflamed. Many children with MIS-C have previously been diagnosed with COVID-19 or have been exposed to COVID-19.

Is MISC-C dangerous?

MIS-C can be serious, but most children have recovered. MIS-C, like Kawasaki disease, can be a very uncomfortable illness because it causes prolonged fever, irritation and inflammation in many tissues of the body. The main concern with MIS-C and Kawasaki disease is heart and blood vessel involvement.

Conditions that involve inflammation in the heart, such as MIS-C or Kawasaki disease, can affect the heart in different ways. They may cause the heart muscle to be irritated and inflamed, affecting the overall function of the heart.

Or, it can weaken the wall of one or more of the coronary arteries causing them to bulge or balloon out. Blood clots can form in the ballooned area and possibly block the blood flow through the coronary artery. When this happens, the heart muscle will no longer receive an adequate supply of oxygen-rich blood, and the heart muscle can be damaged.

Dr. Negar Ashouri, pediatric infectious disease specialist, CHOC Children’s

What are the symptoms of MIS-C?

Though not all children will have the same presentation, these are common symptoms:

  • A fever that won’t go away
  • Abdominal pain, diarrhea or vomiting
  • Bloodshot eyes
  • Rash or changes in skin color

Patients with the following symptoms ought to seek emergency care:

  • Trouble breathing
  • Pain or pressure in the chest that does not go away
  • New confusion
  • Inability to wake or stay awake
  • Bluish lips or face
  • Severe abdominal pain

How is MIS-C diagnosed?

In addition to exploring medical history and performing a physical exam, additional tests may include:

  • Blood tests
  • Echocardiogram 
  • Electrocardiogram
  • Chest X-ray
  • Abdominal ultrasound

How is MIS-C treated?

Kawasaki and MIS-C are best treated in the hospital by a qualified multidisciplinary group of pediatric specialists who will work to to reduce inflammation and minimize long-term heart damage. Treatment may include plasma transfusions to reduce inflammation, steroids, aspirin, antibiotics or supportive oxygen.

Is MIS-C contagious?

MIS-C is not contagious.

What are the long-term effects of MIS-C?

MIS-C is a new illness and medical professionals are actively studying it to learn more,. Children who have had serious cases of MIS-C should be followed by a multidisciplinary group of specialists who will watch oversee their care.

Learn more about the infectious disease team at CHOC Children’s.