Adding to the long list of things nobody understands about this virus ... 

The Centers for Disease Control and Prevention (CDC) has confirmed a connection between COVID-19 and Multisystem Inflammatory Syndrome in Children (MIS-C), a concerning "mystery illness" that has plagued some children across the country.

New York City's health department reports more than 140 cases of MIS-C there, with 90 percent also testing positive for COVID-19 or its antibodies. As of May 15, MIS-C cases had also been identified in patients in 17 states. (Read about a 9-year-old's battle with MIS-C here).

As for symptoms, the following is a graphic comparing those of MIS-C to symptoms of Kawasaki Disease, to which MIS-C has been likened:

MIS-C chart

Courtesy of CovidUp2Date

The following information about MIS-C has been taken directly from the CDC website, in order to limit any misinterpretation of the CDC's official statement.

Multisystem Inflammatory Syndrome in Children (MIS-C)

CDC is collaborating with domestic and international partners to investigate reports of multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19. CDC and partners are working to better understand this new syndrome, including how common it is and its risk factors, and to begin tracking cases.

Patients with MIS-C have presented with a persistent fever and a variety of signs and symptoms including multiorgan (e.g., cardiac, gastrointestinal, renal, hematologic, dermatologic, neurologic) involvement, and elevated inflammatory markers. Not all children will have the same symptoms, and some children may have symptoms not listed here. MIS-C may begin weeks after a child is infected with SARS-CoV-2. The child may have been asymptomatically infected and, in some cases, the child and their caregivers may not even know they had been infected.

For children who may have MIS-C, evaluation for signs of this syndrome may include (but are not limited to) chest radiograph, echocardiography, and blood testing to evaluate for evidence of inflammation. Healthcare providers who have cared or are caring for patients younger than 21 years of age meeting MIS-C criteria should report suspected cases to their local, state, or territorial health department. After-hour phone numbers for health departments are available at the Council of State and Territorial Epidemiologists website. For additional reporting questions, please contact CDC’s 24-hour Emergency Operations Center at 770-488-7100. For more information including a full case definition, please visit the CDC Health Alert Network.

Treatment and Prevention

Currently, there are no specific drugs approved by the U.S. Food and Drug Administration (FDA) for treatment or prevention of COVID-19. Treatment remains largely supportive and includes prevention and management of complications. Healthcare facilities should ensure that infection prevention and control policies and universal source control are in place to minimize chance of exposure to SARS-CoV-2 among providers, patients, and families. For infection prevention and control considerations for infants born to mothers with known or suspected COVID-19, please visit Considerations for Inpatient Obstetric Healthcare Settings. For infection prevention and control considerations for other pediatric healthcare facilities, please visit Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings.

The decision to manage a pediatric patient with mild to moderate COVID-19 in the outpatient or inpatient setting should be decided on a case-by-case basis. Pediatric healthcare providers should consider the patient’s clinical presentation, requirement for supportive care, underlying conditions, and the ability for parents or guardians to care for the child at home. For more information on home care of patients not requiring hospitalization visit: Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for Coronavirus Disease 2019 (COVID-19). There have been limited data on which underlying conditions in children might increase their risk of infection or disease severity. People of all ages, including children and adolescents, with certain underlying medical conditions such as chronic lung disease or moderate to severe asthma, serious heart conditions (e.g., congenital heart defects), immunocompromised conditions (e.g., cancer undergoing treatment), severe obesity (body mass index [BMI]≥40), diabetes, chronic kidney disease on dialysis or liver disease might be at higher risk for severe illness from COVID-19 and should be monitored for symptoms or signs of concern by their caregivers at home and by their clinical providers.

Severe complications associated with COVID-19 in pediatric patients have not been well-described. One newly described severe complication, multisystem inflammatory syndrome (MIS-C), is being investigated by CDC and partners. The treatment of severe and critical cases of pediatric patients with COVID-19 in the hospital may include management of pneumonia, respiratory failure, exacerbation of underlying conditions, sepsis or septic shock, or secondary bacterial infection. Situations in which a patient requires prolonged hospitalization may also result in secondary nosocomial infections.

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Do you know anybody who is fighting MIS-C? Do you have anything to add? Start the discussion in the comments!