While most children who get COVID-19 have a mild or even asymptomatic illness, there are new reports that some children may have a complication that can be severe and dangerous.

Called multisystem inflammatory syndrome in children (MIS-C) by the Centers for Disease Control and Prevention, it can lead to life-threatening problems with the heart and other organs in the body. Early reports compared it to Kawasaki disease, an inflammatory illness that can lead to heart problems. But while some cases look very much like Kawasaki’s, others have been different. Experts think that MIS-C is likely a reaction of the body to either a current or past COVID-19 infection — but there is much we don’t understand, including why some children with MIS-C have negative tests for COVID-19.

What are the symptoms of the new inflammatory syndrome known as MIS-C?

Symptoms of MIS-C vary from case to case, but can include

• prolonged fever (more than a couple of days)
• rash
• conjunctivitis (redness of the white part of the eye)
• stomachache
• vomiting and/or diarrhea
• a large, swollen lymph node in the neck
• red, cracked lips
• a tongue that is redder than usual and looks like a strawberry
• swollen hands and/or feet
• irritability and/or unusual sleepiness or weakness.

There are many other conditions that can cause these symptoms. For example, strep throat can cause fever, rash, swollen lymph nodes, and a “strawberry tongue,” and there are plenty of common viruses that cause stomachache, vomiting, and diarrhea. Doctors make the diagnosis of MIS-C based not just on these symptoms, but also on their physical examination as well as medical tests that check for inflammation and how organs are functioning.

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