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 multisystem inflammatory syndrome in children (MIS-C) from KD and TSS. We report four children with laboratory evidence of severe acute respiratory syndrome - coronavirus - 2 (SARS-CoV-2) infection presenting 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.