Multisystem inflammatory syndrome (MIS-C) in children and adolescents

This Case Report Form (CRF) has been developed to use as a standalone CRF for children and adolescents presenting with syndrome of suspected Multisystem Inflammatory Syndrome (MIS-C).

This CRF has been developed in collaboration with WHO’s working group.

Preliminary case definition  

Children and adolescents 0–19 years of age with measured or self-reported fever ≥ 3 days

AND two or more of the following:

a) Rash or bilateral non-purulent conjunctivitis or mucocutaneous inflammation signs (oral, hands or feet)

b) Hypotension or shock

c) Features of myocardial dysfunction, or pericarditis, or valvulitis, or coronary abnormalities (clinical features, ECHO findings, or laboratory markers such as elevated Troponin/NT-proBNP)

d) Evidence of coagulopathy (such as abnormal PT, PTT, elevated d-Dimers)

e) Acute gastrointestinal problems (such as diarrhea, vomiting, or abdominal pain)


Elevated markers of inflammation such as ESR, C-reactive protein or procalcitonin


No other obvious microbial cause of inflammation, including bacterial sepsis, staphylococcal or streptococcal shock syndromes


Evidence of current or previous COVID-19 (RT-PCR, antigen test or serology positive) or likely contact with patients with COVID.

NB Consider this syndrome in children with features of typical or atypical Kawasaki disease or toxic shock syndrome.



ISARIC MIS-C CRF + completion guide

The CRF has two modules:

1) Module 1 to be completed when multisystem inflammatory syndrome is suspected, on admission or in-patients.

2) Module 2 to be completed at discharge or death.

If the patient is transferred from one ward to another within the same hospital, the CRF should be updated throughout the hospital stay, from the date of admission in the hospital, until the date of transfer to another hospital, discharge from the hospital, or death.