What To Know About Multisystem Inflammatory Syndrome (MIS-C)


As positive cases and hospitalization rates rose to record-breaking levels this spring, northern Michigan parents should be aware of a rare COVID-19 complication in children and young adults called multisystem inflammatory syndrome.

Although this condition has been observed and reported more frequently in adults, the U.S. Centers for Disease Control and Prevention (CDC) is investigating a significant increase in multisystem inflammatory syndrome among children (MIS-C) as part of the COVID-19 pandemic.

“Michigan hospitals are seeing an increase among pediatric patients being admitted with this extremely serious complication, said Christine Nefcy, MD, FAAP, Munson Healthcare Chief Medical Officer. “Parents should be aware of MIS-C and inform a healthcare provider if there are changes in their child’s health.”

What is Multisystem Inflammatory Syndrome in Children (MIS-C)?

children with doctor MIS-C is a delayed immune response from COVID-19 causing inflammation of the heart, lungs, kidneys, brain, skin, eyes, and/or gastrointestinal organs. The CDC reports 99 percent of children diagnosed with MIS-C were also infected with the virus that causes COVID-19. In the remaining one percent of cases, the individuals were in close proximity to a COVID-positive individual.

And much like COVID-19, not all children will have the same symptoms. MIS-C is known to induce a fever sometimes accompanied by a rash, skin discoloration or chapping, chest pain, and gastrointestinal issues such as vomiting and diarrhea. Other reported symptoms include neck pain, bloodshot eyes, and tiredness.

This complication has been observed in otherwise healthy children in addition to those with underlying conditions like obesity. This leads physicians to believe any child may be at risk, not just those with co-morbidities that may have led to a more severe COVID-19 illness.

What Ages Are Most at Risk for MIS-C?

MIS-C was first observed in children and teens in the spring of 2020. Among the CDC’s reported cases:

  • Most were discovered in children and adolescents between the ages of one and 14 years, with a median age of nine.
  • Cases have occurred in children and adolescents from less than one-year-old up to 20 year-olds.
  • 63% percent of reported cases have occurred in children who are Hispanic or Latino, or Black and Non-Hispanic.
  • More than half (59 percent) of reported cases were male.

As of April 29, the state of Michigan has confirmed more than 100 cases of MIS-C in patients aged 20 years and younger. 73 of those cases (68.9%) were admitted to the ICU for treatment.

Although a child’s risk of death from COVID-19 and complications like MIS-C remains low, it’s clear that infections and hospitalizations among children are much higher today than at any other point in the pandemic. That means parents must continue to look for changes in their children’s health – even those who have not tested positive for COVID-19.

What Are the Symptoms of MIS-C?

According to data from the Michigan Health & Hospital Association, MIS-C is most likely to appear 2-5 weeks after a COVID-19 infection. This means, in the wake of our recent surge, northern Michigan families should be aware and prepared in the weeks and months ahead.

“Multisystem inflammatory syndrome in children following a COVID-19 infection can mimic other illnesses,” said Jacques-Brett Burgess, MD, MPH, Hospitalist, Internal Medicine and Pediatrics at Sound Inpatient Physicians in Traverse City. “However, this one is more serious. As a parent or caregiver, please watch your child for significant fevers, abdominal pain, and a rash.”

If you suspect your child is showing signs of MIS-C, please call a pediatrician or other healthcare provider immediately. Seek emergency care if your child is showing warning signs such as:

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

Doctors may prescribe tests to look for inflammation or other signs of disease while helping to ease your child’s symptoms.

“Symptoms typically onset in the weeks following a COVID-19 illness, and please keep in mind your child's COVID-19 infection may have been asymptomatic, which sometimes makes the recognition of MIS-C challenging,” Burgess added.

“It’s crucial to remember that MIS-C is not a viral infection like COVID-19. Instead, an inflammatory response is occurring later. If you have questions about your child's symptoms, please seek prompt medical attention from your primary care provider, local urgent care, or emergency department. Be sure to share your concerns and questions about MIS-C.”

Keeping Your Child Safe from MIS-C

Thankfully, the same ACTions that keep you and your family safe from COVID-19 will help lower your child’s risk of contracting multisystem inflammatory syndrome. Things like:

  • Scheduling your child’s COVID-19 vaccine at the earliest opportunity (for those in authorized age ranges)
  • Keeping your distance (6 or more feet) from people outside your immediate household
  • Wearing your mask when you go out
  • Washing your hands frequently (or use hand sanitizer with 60% or more alcohol)
  • Following your doctor’s trusted advice for recommended appointments, screenings, and treatments

Children are some of our most vulnerable community members and they rely on us to keep them safe and healthy.

Questions? Ask a Nurse!

If you have questions related to MIS-C, COVID-19, or any healthcare topic, please call 231-935-0951 to access our Munson Healthcare Ask-a-Nurse line. We’re here for you 24 hours a day.