Pediatr Infect Vaccine.  2021 Aug;28(2):66-81. 10.14776/piv.2021.28.e13.

Multisystem Inflammatory Syndrome in Children (MIS-C)

  • 1Department of Pediatrics, Chungbuk National University Hospital, Cheongju, the Republic of Korea
  • 2Department of Pediatrics, Chungnam National University Hospital, Daejeon, the Republic of Korea
  • 3Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, the Republic of Korea


The coronavirus disease 2019 pandemic has been continuously spreading throughout the world. As of July 15, 2021, there have been more than 188 million confirmed cases and more than 4.06 million deaths. Although the incidence of severe infections is relatively low in children and adolescents compared to adults, a complication called multisystem inflammatory syndrome in children (MIS-C) may occur in some cases at approximately 2–6 weeks after severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. MIS-C can be seen in patients of various ages, from young infants to adolescents, and may present with diverse clinical manifestations. While fever present in a great majority of patients, symptoms suggesting the involvement of the digestive or nervous system and the skin and mucous membranes (Kawasaki disease-like symptoms) also appear in many cases. Cardiac involvement may also be observed, including left ventricular dysfunction, myocarditis, coronary artery dilatation, and coronary aneurysm. In some cases, hypotension or shock can occur, and mechanical ventilation or treatment in the intensive care unit may be necessary. Fortunately, recovery is generally reported after appropriate treatment. MIS-C is a rare but important complication of SARS-CoV-2 infection in children and adolescents. As such, it is important to recognize the clinical symptoms and provide appropriate treatment at an early stage. In this review, the epidemiology, clinical symptoms, suggested pathophysiology, diagnostic approach, and treatment of MIS-C will be discussed.


COVID-19; Pediatric multisystem inflammatory disease; COVID-19 related; SARS-CoV-2; Child; Therapeutics
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