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. 2022 Apr 11;9(4):538. doi: 10.3390/children9040538

Table 4.

PIMS-TS and MIS-C definition.

Organization Centers for Disease Control and Prevention USA definition Royal College of Pediatrics and Child Health definition
AND
European Centre for Disease Control and Prevention definition		 World Health Organization
Country United States of America United Kingdom and Europe Worldwide
Syndrom/disease name Multisystemic inflammatory syndrome in children (MIS-C) Pediatric inflammatory multisystemic syndrome temporally associated with COVID-19 (PIMS-TS) Multisystemic inflammatory syndrome in children (MIS-C)
Age <21 years All children (age not
defined)		 0–19 years
Clinical symptoms Both of the following:

  1. Severe illness (hospitalized);

  2. ≥2 organ systems involved

 Both of the following:

  1. Single or multiorgan dysfunction;

  2. Additional features

 At least 2 of the following:

  1. Rash, conjunctivitis, and mucocutaneous inflammation;

  2. Hypotension or shock;

  3. Cardiac involvement;

  4. Coagulopathy;

  5. Acute GI symptoms
Inflammation Laboratory evidence of inflammation including, but not limited to, 1 or more of the following:

  1. ↑CRP;

  2. ↑ESR;

  3. ↑Fibrinogen;

  4. ↑Procalcitonin;

  5. ↑D-dimer;

  6. ↑Ferritin;

  7. ↑LDH;

  8. ↑IL-6;

  9. Neutrophilia;

  10. Lymphopenia;

  11. Hypoalbuminemia

 All 3 of the following:

  1. Neutrophilia;

  2. Increased CRP;

  3. lymphopenia

 Elevated inflammation markers, including any of the following:

  1. ↑ESR;

  2. ↑CRP;

  3. ↑Procalcitonin
Link to SARS–CoV-2 Current or recent findings of the following:

  1. Positive by PCR;

  2. Positive by serology;

  3. Positive by antigen test;

  4. COVID-19 exposure within prior 4 weeks

 Positive or negative by PCR Evidence of COVID-19 by the following:

  1. Positive by PCR;

  2. Positive by antigen test;

  3. Positive by serology;

  4. Likely COVID-19 contact
Exclusion No alternative diagnosis Other infections No obvious microbial cause

GI-gastrointestinal, CRP-c-reactive protein, ESR-erythrocyte sedimentation rate, LDH-lactate dehydrogenase, IL-6–interleukin 6. Adapted with permission from John Wiley and Sons [52].