Pediatric Associates of the NW Blogs

COVID-19-Related Pediatric Multisystem Inflammatory Syndrome (PMIS)

Peter Reed, MD, MPH, FAAP
May 26, 2020 09:30AM

A new illness has been in the news and on the minds of parents with young children. Children have largely been spared the worst effects of the novel coronavirus. But a few children have become very sick with a COVID-19-related syndrome: pediatric multisystem inflammatory syndrome (PMIS), or multisystem inflammatory syndrome in children (MIS-C), including at least one child in Oregon.


Here is what we know about this syndrome, and what you need know to take care of your child(ren).


First, PMIS is a very rare complication of novel coronavirus infection and seems to occur three to four weeks after infection. The likelihood of developing PMIS after having coronavirus is quite low.


The syndrome has similarities with two other syndromes that we see in kids and for which we have established treatments: Kawasaki disease and toxic shock syndrome. Clinicians are using treatments for these other syndromes to treat PMIS. That is, we are not starting from scratch in treating this illness. Treatment usually takes place in an intensive care unit with multiple pediatric medical specialties involved.


Children with PMIS have had the following signs or symptoms (frequency in parentheses):

  • Persistent fever, usually three days or more and at least 100.4 degrees Fahrenheit (all cases)
  • Abdominal pain, vomiting, and/or diarrhea (very common)
  • Rash (common)
  • Headache, lethargy, and/or confusion (fairly common)
  • Rapid or labored breathing (fairly common)
  • Conjunctivitis, i.e. red, irritated eyes (fairly common)
  • Sore throat (not very common)
  • Swollen hands or feet (not common)


The diagnosis of the syndrome is made with a combination of a careful patient history, physical exam, and laboratory findings (bloodwork).


If you are concerned that your child might have COVID-19 or PMIS, please call Pediatric Associates of the Northwest for advice and/or an appointment. Early diagnosis and treatment are critical. If it is a potentially life-threatening emergency, call 911.


PMIS is a rare but nonetheless alarming syndrome related to COVID-19. There are many things that you can do to protect yourself, your child(ren), your neighbors, and your community from the novel coronavirus.

  • Wash hands frequently
  • Wear a mask when out in public
  • Maintain a safe social distance of at least six feet
  • Avoid touching your face
  • Venture out only when necessary, and
  • Stay close to home.


We urge you to abide by the public health directives and advice from these reliable sources: Dr. Anthony Fauci (Director of the National Institute of Allergy and Infectious Diseases), the Centers of Disease Control (CDC), Governor Kate Brown, the Oregon Health Authority, and local public health officials.


Together, six feet apart, we can minimize the spread of the novel coronavirus.


Schedule an appointment online or call our offices. Convenient virtual telehealth visits available. 



  1. Oregon Health Authority
  2. UpToDate