Skip to main content Skip to main navigation menu Skip to site footer

A review of multisystem inflammatory syndrome in children (MIS-C) related to COVID-19


Global pandemic of Coronavirus Disease 2019 (COVID-19) caused by SARS-CoV-2, a novel virus which first reported in Wuhan in December 2019. It can cause severe respiratory conditions including respiratory failure. Different from adults, children usually have milder symptoms of the disease. A post-infection complication that involves multisystem organ failure in children is reported in numerous countries. It is mentioned as multisystem inflammatory syndrome in children (MIS-C) or Kawa-COVID-19, because it resembles Kawasaki Disease. The pathogenesis remains unclear, but it is presumed that hosts’ innate immune response triggered the condition. Modulating the immune response is the main target of the therapy. High doses of intravenous immunoglobulins, low doses of corticosteroids (methylprednisolone), anti-IL-1 (anakinra), antiplatelet such as aspirin can be used to treat MIS-C. Antiviral therapy is not proven to be effective and other immunomodulatory agents still needed further studies.


  1. Jiang L, Tang K, Levin M, Irfan O, Morris SK, Wilson K et al. COVID-19 and multisystem inflammatory syndrome in children and adolescents. Lancet Infect Dis. 2020;20:e276–e288.
  2. Diorio C, Henrickson SE, Vella LA, McNerney KO, Chase J, Burudpakdee C et al. Multisystem inflammatory syndrome in children and COVID-19 are distinct presentations of SARS-CoV-2. J Clin Invest. 2020;130:5967–5975.
  3. Feldstein LR, Rose EB, Horwitz SM, Collins JP, Newhams MM, Son MBF et al. Multisystem Inflammatory Syndrome in U.S. Children and Adolescents. N Engl J Med. 2020;383:334–346.
  4. WHO. Coronavirus disease (COVID-19) pandemic [Online]. 2020. Available at: (accessed 26 Nov2020).
  5. Pranita E. High icidens of COVID-19 in child in Asia, what are the cause? [Online]. 2020. Availavle at: (accessed 26 Nov2020).
  6. Ebina-Shibuya R, Namkoong H, Shibuya Y, Horita N. Multisystem Inflammatory Syndrome in Children (MIS-C) with COVID-19: Insights from simultaneous familial Kawasaki Disease cases. Int J Infect Dis. 2020;97:371–373.
  7. Toubiana J, Poirault C, Corsia A, Bajolle F, Fourgeaud J, Angoulvant F et al. Kawasaki-like multisystem inflammatory syndrome in children during the covid-19 pandemic in Paris, France: prospective observational study. BMJ. 2020;369:m2094.
  8. Pouletty M, Borocco C, Ouldali N, Caseris M, Basmaci R, Lachaume N et al. Paediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2 mimicking Kawasaki disease (Kawa-COVID-19): a multicentre cohort. Ann Rheum Dis. 2020;79:999–1006.
  9. American Academy of Pediatrics. Multisystem Inflammatory Syndrome in Children (MIS-C) Interim Guidance. 2020. (accessed 26 Nov2020).
  10. Pang J, Boshier FAT, Alders N, Dixon G, Breuer J. SARS-CoV-2 Polymorphisms and Multisystem Inflammatory Syndrome in Children. Pediatrics. 2020;12:e2020019844.
  11. Li Y, Zhou W, Yang L, You R. Physiological and pathological regulation of ACE2, the SARS-CoV-2 receptor. Pharmacol Res. 2020;157:104833.
  12. Henderson LA, Canna SW, Friedman KG, Gorelik M, Lapidus SK, Bassiri H et al. American College of Rheumatology Clinical Guidance for Multisystem Inflammatory Syndrome in Children Associated With SARS–CoV‐2 and Hyperinflammation in Pediatric COVID‐19: Version 1. Arthritis Rheumatol. 2020;72:1791–1805.
  13. Lee PY, Day-Lewis M, Henderson LA, Friedman KG, Lo J, Roberts JE et al. Distinct clinical and immunological features of SARS-CoV-2-induced multisystem inflammatory syndrome in children. J Clin Invest. 2020;130:5942–5950.
  14. Kanegaye JT, Wilder MS, Molkara D, Frazer JR, Pancheri J, Tremoulet AH et al. Recognition of a Kawasaki Disease Shock Syndrome. Pediatrics. 2009;123:e783–e789.
  15. Grimaud M, Starck J, Levy M, Marais C, Chareyre J, Khraiche D et al. Acute myocarditis and multisystem inflammatory emerging disease following SARS-CoV-2 infection in critically ill children. Ann Intensive Care. 2020;10:69-75.
  16. Ramcharan T, Nolan O, Lai CY, Prabhu N, Krishnamurthy R, Richter AG et al. Paediatric Inflammatory Multisystem Syndrome: Temporally Associated with SARS-CoV-2 (PIMS-TS): Cardiac Features, Management and Short-Term Outcomes at a UK Tertiary Paediatric Hospital. Pediatr Cardiol. 2020;41:1391–1401.
  17. Whittaker E, Bamford A, Kenny J, Kaforou M, Jones CE, Shah P et al. Clinical Characteristics of 58 Children With a Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2. JAMA. 2020;324:259–269.
  18. Sperotto F, Friedman KG, Son MBF, VanderPluym CJ, Newburger JW, Dionne A. Cardiac manifestations in SARS-CoV-2-associated multisystem inflammatory syndrome in children: a comprehensive review and proposed clinical approach. Eur J Pediatr. 2021;180(2):307-322.
  19. Kim K-D, Hwang I, Ku KB, Lee S, Kim S-J, Kim C. Progress and Challenges in the Development of COVID-19 Vaccines and Current Understanding of SARS-CoV-2- Specific Immune Responses. J Microbiol Biotechnol. 2020;30:1109–1115.
  20. Rowley AH. Understanding SARS-CoV-2 related multisystem inflamatory syndrome in children. Nat Rev Immunol. 2020;20:453-454.
  21. American College of Rheumatology. Clinical guidance for pediatric patient with multisystem inflamatory syndrome in children (MIS-C) associated with ARS-CoV-2 and gyperinflammation in COVID-19 [Online]. 2020; Available at:

How to Cite

Kurniawan, C. (2022). A review of multisystem inflammatory syndrome in children (MIS-C) related to COVID-19. Intisari Sains Medis, 13(3), 670–673.




Search Panel

Carlson Kurniawan
Google Scholar
ISM Journal