Mighty Blog

Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19

Last update: 5/20/2020.

As experts learn more about the newest coronavirus, COVID-19, spreading throughout the world, they are learning of new complications related to the illness. One complication that may be especially concerning to parents is the possibility of children with COVID-19 also developing an exaggerated immune response to the virus that causes inflammation across many organs.

This new entity is being called Multisystem Inflammatory Syndrome in Children (MIS-C). This “immune system overdrive” triggers an inflammation of the heart and blood vessels, resulting in blood clots and symptoms of shock. It occurs up to three months after a child has had COVID-19. Even though very few cases of MIS-C have been described worldwide, doctors noted that MIS-C is both like Kawasaki disease and different.

We’re explaining what parents need to know about the possible relationship between COVID-19 and Kawasaki-like symptoms.

What is Kawasaki disease?

Kawasaki disease is an illness that causes inflammation, like swelling and redness, in blood vessels throughout the body. This disease typically affects young children under the age of 5. While this can all sound scary, it’s important to remember that most children with Kawasaki disease will recover completely, especially if they are diagnosed and treated early. The cause of Kawasaki disease is still unknown.

Symptoms of Kawasaki disease

Kawasaki disease is generally a prolonged illness, and one of the signs of the illness is often a lasting fever. Fever can also be a symptom of COVID-19. Here are the Kawasaki-like symptoms kids may experience after contracting COVID-19:

  • A fever that won’t go away after 4 or more days.
  • Abdominal pain, diarrhea or vomiting.
  • A rash or change in skin color or peeling skin of the finger tips.
  • Trouble breathing.
  • Overly sleepy.
  • Red eyes.
  • Bright red or cracked lips.
Mother taking daughter's temperature while she is in bed.

How are COVID-19 and MIS-C related?

In late April, the first case of a pediatric COVID-19 patient developing symptoms of Kawasaki disease was reported. Other cases have been reported around the country and around the world; however, what is unusual is that this entity is occurring more frequently in children over the age of 5 and children of all ethnicities, whereas Kawasaki disease has a higher incidence in younger Asian children.

Presenting symptoms of MIS-C are fever, abdominal pain (which is almost universal), rash and conjunctivitis (like pink eye). Children with symptoms of MIS-C need medical attention promptly. In a small case report nearly half of the children had coronary disease early in their disease. All had been previously diagnosed with COVID-19 or had antibodies to the viral illness. There are dramatically increased inflammatory markers in lab tests, and some elevated blood tests related to blood clot formation.

It’s important to know that Kawasaki disease itself is a very rare illness, and this new entity is even more rare. Experts are learning more about this every day from around the world and our knowledge of this entity is changing quickly.

If you are concerned that your child may have COVID-19 or is experiencing any of these symptoms, please contact your child’s pediatrician right away. They can help you decide what the best next steps are for your child and family.

More information is available on the Minnesota Department of Health website: Health Advisory: Multisystem Inflammatory Syndrome in Children (MIS-C).