Although 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
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
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.
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:
- digestive system
These symptoms may look like this:
- a rash on their skin
- bloodshot eyes
- diarrhea and/or vomiting
- tummy pain
- feeling dizzy
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
- difficulty breathing
- chest pain or pressure
- seeming suddenly disoriented
- extreme lethargy, can’t be awoken
- gray, blue, or pale skin, lips, or fingernails
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.
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
- are under 21 years old
- have a fever
- have inflammation in multiple organs
- are 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 tests
- urine tests
- ultrasound of your child’s abdomen
- X-rays of your child’s chest
- electrocardiogram (EKG) or ultrasound of your child’s heart
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 medications
- intravenous (IV) fluids
- immune system antibodies given via IV
- heart 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.
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,
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 13
- being male
- having any
life-limiting underlying condition
- being in a
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.
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.
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.
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.
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.