COVID-19 related multisystem inflammatory syndrome in children (MIS-C): a case series from a tertiary care hospital in Sri Lanka

Although it has clinical features that overlap with Kawasaki disease (KD) and toxic shock syndrome (TSS), an intense inflammatory storm distinguishes MIS-C. We report four children with laboratory evidence of Severe Acute Respiratory Syndrome - coronavirus - 2 (SARS-CoV-2) infection presented with persistent fever, mucocutaneous signs, and raised inflammatory markers associated with remarkable multi-organ involvement, particularly that of the gastrointestinal and cardiovascular systems. All of them responded well to immunosuppressive therapy, including intravenous immunoglobulin and methylprednisolone. The distinguishing clinical characteristics found in MIS-C include the age of the child, gastrointestinal symptoms, and hypotension without coronary involvement. Immediate medical care is needed for a better outcome, and most children need management in an intensive care unit.