New spectrum of COVID-19 manifestations in children: Kawasaki-like syndrome and hyperinflammatory response

Sirada Panupattanapong; Elizabeth B. Brooks

doi:10.3949/ccjm.87a.ccc039

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TABLE 1

Case definition for Multisystem Inflammatory Syndrome in Children (MIS-C)

An individual < 21 years presenting with

• Fever,^a laboratory evidence of inflammation,^b and evidence of clinically severe illness requiring hospitalization, with multisystem (> 2) organ involvement (cardiac, renal, respiratory, hematologic, gastrointestinal, dermatologic or neurological); AND

• No alternative plausible diagnoses; AND

• Positive for current or recent SARS-CoV-2 infection by RT-PCR, serology, or antigen test; or COVID-19 exposure within the 4 weeks prior to the onset of symptoms

Additional comments

• Some individuals may fulfill full or partial criteria for Kawasaki disease but should be reported if they meet the case definition for MIS-C

• Consider MIS-C in any pediatric death with evidence of SARS-CoV-2 infection

↵a Fever > 38.0°C for ≥ 24 hours, or report of subjective fever lasting ≥ 24 hours.
↵b Including, but not limited to, 1 or more of the following: an elevated C-reactive protein, erythrocyte sedimentation rate, fibrinogen, procalcitonin, d-dimer, ferritin, lactic acid dehydrogenase, or interleukin 6, elevated neutrophils, reduced lymphocytes and low albumin.
RT-PCR = reverse transcription polymerase chain reaction
Reproduced from Centers for Disease Control and Prevention website.⁷