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What Parents Need To Know About MIS-C

This COVID-19 complication in children is serious, but thankfully rare and easy to identify.
This COVID-19 complication in children is serious, but thankfully rare and easy to identify. Photo Credit: Phelps Hospital

Dear Doctor,

As the parent of three young kids, I’m kind of freaked out by the recent news that there’s a new life-threatening complication of COVID-19 in children. What do we know about this problem, and how worried should I be?


“Panicked Parent”

Dear Panicked:

It’s totally understandable that you’re concerned about this new complication called multisystem inflammatory syndrome in children (MIS-C). Since MIS-C is so new (it was first identified in April), there’s still a lot that we don’t know about it. But we are fairly confident that it’s related to the coronavirus as all of the children treated for this condition at our institution have tested positive for COVID-19 antibodies.

MIS-C has a lot of similarities to a rare childhood illness called Kawasaki disease, including:

  • Persistent fever, meaning a fever of 100.4 degrees or higher that lasts for more than a couple of days
  • Gastrointestinal symptoms such as abdominal pain, vomiting, and diarrhea
  • Rash
  • Red eyes, lips, and/or tongue
  • Swollen hands and feet

Like Kawasaki disease, MIS-C can cause an inflammation of the blood vessels and can directly affect the heart muscle itself. A large percentage of the pediatric patients we’ve seen have developed heart muscle inflammation and about half have developed coronary artery abnormalities. Those are the problems we really worry about because when these heart abnormalities are left untreated, kids can develop serious and potentially life-threatening complications such as aneurysms.

If we suspect a child has MIS-C based on their symptoms, bloodwork will be ordered. If the tests show that their inflammatory markers are elevated, the child will be admitted to the hospital for treatment and evaluated by a pediatric cardiologist.

It’s good to keep in mind that MIS-C is relatively rare. I’m a parent, too, and I haven’t changed anything that I’m doing as a result of this new syndrome, other than reinforcing what we already know is most important to try to prevent coronavirus infections. This means social distancing, hand hygiene, and wearing a mask when you’re not able to maintain 6 feet from other people.

It’s important that kids who have symptoms of MIS-C be seen by a pediatrician as soon as possible. This is true even if a child has never been diagnosed with or suspected of having COVID-19. At our hospital, most of the children we’ve treated for MIS-C didn’t have any symptoms of COVID-19, and some of them didn’t even know they had it until they tested positive for antibodies. This reinforces what we’ve suspected for some time, which is that a significant proportion of kids are asymptomatic carriers of the virus.

If your child has a persistent fever that’s combined with any of the other symptoms above, call your pediatrician’s office and ask to have them evaluated for MIS-C. And you shouldn’t hesitate to bring your child to the pediatrician’s office because you’re worried about potential exposure to the coronavirus. A lot of work has been done in pediatricians' offices to minimize the risk of the transmission of all infectious diseases, but especially COVID-19.