COVID-19 & Rare Diseases

Genomics of Multisystem Inflammatory Syndrome in Children (MIS-C)

As part of the GUaRDIAN initiative on Rare Genetic Diseases, we work with clinicians and clinical centres to understand the genetic underpinnings of MIS-C

If you are a clinician / pediatrician and have a cohort of pediatric patients satisfying the clinical criteria of MIS-C, please contact Dr. Vinod Scaria at vinods[at] OR Dr. Sridhar Sivasubbu at sridhar[at]

Multisystem Inflammatory Syndrome in Children (MIS-C)

As described in the CDC Health Advisory, the case definition for MIS-C is:

  • 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 exposure to a suspected or confirmed COVID-19 case 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

Additional comments:

  • Some individuals may fulfill full or partial criteria for Kawasaki disease but should be reported if they meet the case definition for MIS-C.

  • Consider MIS-C in any pediatric death with evidence of SARS-CoV-2 infection.


Cotsapas C, Saarela J, Farmer JR, Scaria V, Abraham RS.Do monogenic inborn errors of immunity cause susceptibility to severe COVID-19?J Clin Invest. 2021 Jun 1:149459. doi: 10.1172/JCI149459 .
Devassikutty, FM, Jain A, Edavazhippurath A, Joseph MC, Peedikayil MNT, Scaria V, Sandhya P, and Govindaraj GM.X-Linked Agammaglobulinemia and COVID-19: Two Case Reports and Review of LiteraturePediatric Allergy, Immunology, and Pulmonology.Sep 2021.115-118.