COVID 19 & CHILDREN brought to you by the Texas EMS for Children (EMSC) State Partnership

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Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with Coronavirus Disease 2019 (COVID-19)

On May 14, the Centers for Disease Control and Prevention (CDC) issued a HAN alert on Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with Coronavirus Disease 2019 (COVID-19).

"The Centers for Disease Control and Prevention (CDC) is providing 1) background information on several cases of a recently reported multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19); and 2) a case definition for this syndrome. CDC recommends healthcare providers report any patient who meets the case definition to local, state, and territorial health departments to enhance knowledge of risk factors, pathogenesis, clinical course, and treatment of this syndrome."

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

  • An individual aged <21 years presenting with feveri, laboratory evidence of inflammationii, 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

iFever >38.0°C for ≥24 hours, or report of subjective fever lasting ≥24 hours

iiIncluding, but not limited to, one or more of the following: an elevated C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen, procalcitonin, d-dimer, ferritin, lactic acid dehydrogenase (LDH), or interleukin 6 (IL-6), elevated neutrophils, reduced lymphocytes and low albumin

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

The current COVID-19 pandemic may not affect children as much as the rest of the population, but it has exacerbated the need to increase disease and injury prevention efforts as children spend more time around the home.


Child abuse might go underreported during the pandemic as children spend more time at home then schools, where authorities rely on teachers and school nurses to report cases of potential child abuse. As shelter at home orders continue and schools remain closed, it remains everyone's responsibility to ensure that children feel safe in the environment they share with their families. Below are a few helpful resources.



OPENPediatrics is providing a collection of instructional videos to help healthcare providers care for pediatric patients during the pandemic.

MASSACHUSETTS EMSC has provided brief professional produced video clips for their Pediatric Emergency Care Coordinators (PECC). The video are meant to help professionals create a more family-centered environment for their emergency departments. In addition to helping children through minor procedures, the techniques presented in the videos also help the staff to feel more comfortable when a child presents requiring laceration repair, abscess I&D, etc.


The Emergency Medical Services for Children (EMSC) State Partnership, Texas is a statewide collaborative project funded through the Health Resource and Services Administration’s EMS for Children Program. Baylor College of Medicine is the site of the Texas EMSC office and is working in partnership with the largest children’s hospitals in Texas, their affiliated colleges of medicine, and representatives of the Texas Department of State Health Services. Through this collaboration, the EMSC State Partnership, Texas has created the infrastructure to assess and achieve defined EMSC Performance Measures. In addition, the EMSC State Partnership, Texas works tirelessly to improve education, research and pediatric pre hospital care. For more information, please visit www.bcm.edu/pediatrics/emsc.

This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.

1102 Bates Ave Ste C1850 | Houston, TX 77030 | (832) 824 3672 | emsctexas@bcm.edu

Updated on August 21, 2020

Created By
Texas EMSC


Created with images by BlenderTimer - "coronavirus corona virus" • Annie Spratt - "untitled image" • camilo jimenez - "untitled image" • Helena Lopes - "Saturday. Summer. Beautiful sunny day, so my friends and I decided to make a picnic and watch the sundown. Pretty fun and relaxed day." • Senjuti Kundu - "This is two-year-old Malki, her name means Queen in Yiddish. We were at the park playing with paint and bubbles and this shot was a remarkably lucky one since toddlers move so fast. This photo is important to me because it captures her innocence and reminds me how happy and carefree I was that day, hanging out with her." • MI PHAM - "Children’s smile" • Jerry Wang - "untitled image" • DariuszSankowski - "phone mobile telephone" • Mr Cup / Fabien Barral - "A stack of old newspapers"