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 Photos  Search by image Caring mom call ambulance for sick small daughter.

Multisystem Inflammatory Syndrome in Children: Condition Linked to COVID-19

By Dr. Kimberly Schindler, Pediatric Associates

Most parents are all too familiar with COVID-19 by now, but they may not know as much about multisystem inflammatory syndrome in children, or MIS-C.

The condition is associated with exposure to COVID-19 and causes different areas of the body to become inflamed, such as the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. The condition is rare but can be life-threatening without treatment. So, it’s important for parents to be aware of the signs to watch for.

There’s still much to be learned about MIS-C, but it occurs an average of four weeks after exposure to COVID-19. The child may not have shown any symptoms of COVID, and parents may not be aware their child has had it. But, often, another family member has tested positive. A key diagnostic clue is that the child’s blood contains antibodies to the virus that causes COVID-19.

What are the symptoms?

Ongoing fever, plus more than one of the following:

  • Stomach pain.
  • Bloodshot eyes.
  • Diarrhea.
  • Dizziness or lightheadedness (signs of low blood pressure).
  • Skin rash.
  • Vomiting.

When to seek emergency care:

  • Trouble breathing.
  • Pain or pressure in the chest that does not go away.
  • Confusion or unusual behavior.
  • Severe abdominal pain.
  • Inability to wake or stay awake.
  • Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone.

This list does not include all possible symptoms. Please call a medical provider for any other symptoms that are severe or concerning to you.

If your child needs emergency care, call 911 or call ahead to your local emergency facility: Notify the operator that you are seeking care for someone who has or may have COVID-19.

What is the treatment?

Treatment will vary according to your child’s symptoms and test results, but may include the following:

  • Steroids to help treat swelling or inflammation.
  • Intravenous immune globulin (IVIG), a biologic medicine that contains immune-system antibodies.
  • Fluids given through a vein.
  • Heart medications.
  • Extracorporeal membrane oxygenation (ECMO) therapy, in extreme cases. ECMO takes over the work of the lungs, or both the heart and lungs, to support children while other treatments help them recover from serious medical conditions.

If your child is hospitalized with MIS-C, the hospital team will arrange several follow-up appointments after your child has gone home. Children with MIS-C likely will need to see a pediatric cardiologist several weeks after leaving the hospital. MIS-C can cause the wall of the heart to be inflamed ( myocarditis). Children may also need to follow up with a pediatric rheumatologist.


The best way to prevent MIS-C is for all eligible children to get the COVID-19 vaccine and keep taking steps to help avoid exposure to the virus. For example, remember to:

  • Wash hands often using soap and water for 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.
  • Avoid people who are sick and keep at least a 3-foot distance between your unvaccinated child and people outside your household.
  • Wear face masks indoors in public in areas with high or substantial transmission, even if fully vaccinated.
  • Clean and disinfect high-touch surfaces daily.

Read one family's experience with MIS-C.

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About CHKD Medical Group

About CHKD Medical  Group Children’s Hospital of The King’s Daughters has been the region’s most trusted name in pediatric care for more than 50 years. As members of CHKD Health System, our pediatricians work closely with CHKD’s full range of pediatric specialists and surgeons. They also share a commitment to quality, excellence and child-centered care. With 18 practices in 29 locations throughout the region, a CHKD pediatrician is never far.