multisystem inflammatory syndrome in children


CDC's and WHO's defination of MIS-C chart

Imaging findings are variable and may be present before symptoms. In a systematic review that included 674 children with confirmed COVID-19 infection who underwent imaging, approximately 50 percent had abnormalities.  Among 605 children who underwent computed tomography, 33 percent had normal findings, 29 percent had ground glass opacities, 27 percent had nonspecific unilateral findings, and 23 percent had bilateral findings.

Imaging findings

-  The complete blood count was normal in most children; 17 percent had low white blood cell count and 13 percent had either neutropenia or lymphocytopenia; severe neutropenia has been described
-  Approximately one-third had elevated C-reactive protein (CRP; defined as >5 mg/L in most studies) or procalcitonin (defined as >0.5 ng/mL)
-  Elevated inflammatory markers and lymphocytopenia may indicate multisystem inflammatory syndrome in children (MIS-C)
-  Creatine kinase was elevated in 15 percent
-  Serum aminotransferases were elevated in 12 percent

Ohio State University, Columbus

-  ages 0-9
-  ages 10-19
-  infants <12 months of age
-  Laboratory findings of children below 18 years of age

Clinical findings in children of all ages

Deville, J. (2020, August 7). Coronavirus disease 2019 (COVID-19): Clinical manifestations and diagnosis in children. Retrieved August 13, 2020, from https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19-clinical-manifestations-and-diagnosis-in-children?topicRef=127535

Coronavirus disease 2019 (COVID-19): Clinical manifestations and diagnosis in children

-  Fever, cough, or shortness of breath – 60 percent

-  Fever – 35 percent

-  Cough – 41 percent

-  Shortness of breath – 16 percent

-  Myalgia – 30 percent

-  Rhinorrhea – 8 percent

-  Headache – 42 percent

-  Nausea/vomiting – 10 percent

-  Abdominal pain – 8 percent

-  Diarrhea – 14 percent

-  Loss of smell or taste – 10 percent

Clinical findings on ages 10-19 yrs of age

-  Fever, cough, or shortness of breath – 63 percent

-  Fever – 46 percent

-  Cough – 37 percent

-  Shortness of breath – 7 percent

-  Myalgia – 10 percent

-  Rhinorrhea – 13 percent

-  Headache – 15 percent

-  Nausea/vomiting – 10 percent

-  Abdominal pain – 7 percent

-  Diarrhea – 14 percent

-  Loss of smell or taste – 1 percent

Clinical findings on ages 0-9 yrs of age

-  Gastrointestinal symptoms may occur without respiratory symptoms 
-  Diarrhea, vomiting, and abdominal pain are the most common gastrointestinal symptoms reported in children 
-  Gastrointestinal bleeding has been reported in adults but has not been reported in children
-  Reddish-purple nodules on the distal digits


Clinical manifestations

In a systematic review of 25 infants ≤3 months of age with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, 5 were asymptomatic, 12 had mild symptoms, 5 had moderate symptoms, and 3 had severe symptoms.  Symptoms included fever, cough, dyspnea, vomiting, and feeding intolerance. Two infants were treated in the intensive care unit (ICU) and one required mechanical ventilation. Additional clinical findings include feeding difficulty and fever without an obvious source

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