Our suggested approach to the evaluation of patients with suspected COVID-19-associated multisystem inflammatory syndrome in children (MIS-C)

COVID-19: coronavirus disease 2019; KD: Kawasaki disease; TSS: toxic shock syndrome; GI: gastrointestinal; CBC: complete blood count; CRP: C-reactive protein; ESR: erythrocyte sedimentation rate; BUN: blood urea nitrogen; LFTs: liver function tests; LDH: lactate dehydrogenase; PT: prothrombin time; INR: international normalized ratio; aPTT: activated partial thromboplastin time; BNP: brain natriuretic peptide; NT-pro-BNP: N-terminal pro-BNP; ECG: electrocardiogram; SARS-CoV-2: severe acute respiratory syndrome coronavirus 2; PCR: polymerase chain reaction; CXR: chest radiograph; CDC: Centers for Disease Control and Prevention; WHO: World Health Organization; EBV: Epstein-Barr virus; CMV: cytomegalovirus.
* Evaluation for MIS-C may be appropriate in children with a shorter duration of fever if they have severe manifestations.
¶ In children with moderate or severe manifestations, testing for other pathogens generally includes blood, urine, stool, and throat cultures; respiratory viral panel; and testing for EBV, CMV, enterovirus, and adenovirus. In children presenting with mild symptoms, microbiologic testing should be done as clinically indicated according to the age of the child and their specific symptoms (eg, throat culture if the child has a sore throat, respiratory viral panel if there are respiratory symptoms).