One Important Thing: MIS-C

Each week, VACEP brings you “One Important Thing” to know related to emergency medicine in Virginia.

One Important Thing: There are reports in New York and the U.K. of multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19. This week, the Virginia Department of Health asked state healthcare providers to immediately and rapidly report any patient who meets certain case criteria to the local health department. 

Public health officials developed a standardized case definition for suspected cases.

Case definition:

• An individual aged <21 years presenting with fever*, laboratory evidence of inflammation**, 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

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

**Including, 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