Coronavirus

Infographic: Early Cases of MIS-C: Multi-System Inflammatory Syndrome in U.S. Children

Infographic: Early Cases of MIS-C: Multi-System Inflammatory Syndrome in U.S. Children The following infographic highlights key data from a CDC-authored study on MIS-Cexternal icon published in June 2020, in the New England Journal of Medicine. The study was conducted using Overcoming COVID-19, a CDC-funded evaluation, which seeks to understand severe COVID-19 among children and young adults…

Infographic: Early Cases of MIS-C: Multi-System Inflammatory Syndrome in U.S. Children

The following infographic highlights key data from a CDC-authored study on MIS-Cexternal icon published in June 2020, in the New England Journal of Medicine. The study was conducted using Overcoming COVID-19, a CDC-funded evaluation, which seeks to understand severe COVID-19 among children and young adults up to age 25 by leveraging a national network of pediatric health centers. The study evaluated patients admitted for multi-system inflammatory syndrome in children (MIS-C) to participating health centers from March 15, 2020 through May 20, 2020. Read more about MIS-C case demographics in the United States.

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Infographic: Tracking MIS-C: Multi-System Inflammatory Syndrome in U.S. Children

Tracking MIS-C (Text Version)

Tracking MIS-C: Multi-System Inflammatory Syndrome in U.S. Children

186 MIS-C Cases, 26 states

March 15-May 20, 2020

Epidemiology of MIS-C

Hospital-reported MIS-C Cases by State:

  • 16 states reported 1-6 cases
  • 4 states reported 7-14 cases
  • 1 state reported 15-21 cases
  • 4 states reported 22-29 cases

MIS-C and COVID-19 Activity

[Chart showing percentage of positive COVID-19 tests and number of MIS-C cases from March 15-May 20]

By leveraging a national influenza surveillance network of pediatric ICUs[i], CDC and partners conducted targeted surveillance for MIS-C from March 15 through May 20, 2020, identifying 186 MIS-C cases in 26 states.

Gender

  • 62% male
  • 38% female

Age

  • 7%, <1
  • 28%, 1-4
  • 25%, 5-9
  • 24%, 10-14
  • 16%, 15-20

Percentage of U.S. Children with MIS-C, by race and ethnicity*

  • 31% Hispanic or Latino
  • 25% Black, non-Hispanic
  • 19% white, non-Hispanic
  • 5% other, non-Hispanic
  • 22%, unknown

*race categories were non-exclusive

Cases Met 5 Criteria

  1. Hospitalized patients < 21 years
  2. Fever ≥ 24 hours
  3. Laboratory evidence of inflammation
  4. ≥ 2 organs involved
  5. Evidence of SARS-CoV-2[ii] by RT-PCR[iii], antibody test, or exposure to a person with COVID-19 in the prior month

Impact on the Cardiovascular System

Percentage of Patients with Impact on the Heart

  • Any CVI[iv] (80%)
  • Elevated troponin (50%)
  • B-type natriuretic peptide (BNP) > 400 (73%)
  • Echocardiography performed (91%)
  • Pericarditis or pericardial effusion (26%)
  • Ejection fraction of < 30% (5%)
  • Ejection fraction of 30 to < 55% (33%)
  • Ejection fraction ≥ 55% (62%)
  • Z-score of LAD

or RCA[vi] ≥2.5* (8%)

  • Dysrhythmia/arrhythmia (12%)
  • Vasopressor support/Vasoactive infusions (48%)
  • ECMO[vii] (4%)

*among all MIS-C cases

Impact on Other Organs, by Age

Percentage of MIS-C Patients with Impact on Other Organs

Percentage of MIS-C Patients with Laboratory Evidence of Inflammation, by Age

Treatment

  • Intravenous Immunoglobulin (IVIg) (77%)
  • Second dose IVIg (21%)
  • Systemic Steroids (49%)
  • Il-6 Inhibitors (tocilizumab and siltuximab) (8%)
  • Il-1Ra Inhibitor (anakinra) (13%)
  • Systemic Anticoagulation (47%)

Highest Level of Care

  • Ward (20%)
  • Intensive Care Unit (80%)

Intensive Care Interventions

  • ECMO (4%)
  • Mechanical Ventilation (20%)
  • Vasoactive Support (48%)

Outcomes

  • Median Hospitalization, 7 days
  • Still Hospitalized May 20,2020 (28%)
  • Discharged alive (70%)
  • Died (2%)

Percentage of U.S. MIS-C Patients with Features of Kawasaki Disease (KD) and Other Diseases

**among those with echocardiograms (n=170)
*This category includes patients who had 0 or 1 Kawasaki disease-like features or 2 or 3 features without add

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