Side-by-Side Comparison of Criteria Included in the 2020 CDC MIS-C Case Definition and in the CSTE/CDC MIS-C Surveillance Case Definition
| Criterion . | 2020 CDC MIS-C Case Definition . | CSTE/CDC MIS-C Surveillance Case Definition . |
|---|---|---|
| Patient age | <21 y | <21 y |
| Hospitalization | Clinically severe illness requiring hospitalization | Clinical severity requiring hospitalization or resulting in death |
| No alternative diagnosis | No alternative plausible diagnoses | Absence of a more likely alternative diagnosis |
| Fever | Fever ≥38.0°C for ≥24 h, or report of subjective fever lasting ≥24 h | Subjective or documented fever (temperature ≥38.0°C) |
| Laboratory evidence of systemic inflammation | Including, but not limited to, 1 or more of the following: an elevated C-reactive protein, erythrocyte sedimentation rate, fibrinogen, procalcitonin, d-dimer, ferritin, lactic acid dehydrogenase, or interleukin 6, elevated neutrophils, reduced lymphocytes and low albumin | C-reactive protein ≥3.0 mg/dL (30 mg/L) |
| Evidence of SARS-CoV-2 infection or exposure | 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 wks before the onset of symptoms | Detection of SARS-CoV-2 RNA in a clinical specimen up to 60 d before or during hospitalization, or in a postmortem specimen using a diagnostic molecular amplification test (eg, PCR), OR |
| Detection of SARS-CoV-2-specific antigen in a clinical specimen up to 60 before or during hospitalization, or in a postmortem specimen, OR | ||
| Detection of SARS-CoV-2-specific antibodies in serum, plasma, or whole blood associated with current illness resulting in or during hospitalization, OR | ||
| Close contact with a confirmed or probable case of COVID-19 in the 60 d before hospitalization | ||
| Multisystem involvement | Multisystem (≥2) organ involvement: | New onset manifestations in at least 2 of the following categories: |
| Cardiovascular (eg, shock, elevated troponin and/or BNP, abnormal echocardiogram, arrhythmia) | Cardiac involvement indicated by left ventricular ejection fraction <55%, OR coronary artery dilatation, aneurysm, or ectasia, OR troponin elevated to greater than laboratory normal range, or indicated as elevated in a clinical note | |
| Renal (eg, acute kidney injury, renal failure) | Mucocutaneous involvement indicated by rash, OR inflammation of the oral mucosa (eg, mucosal erythema or swelling, drying, or fissuring of the lips, strawberry tongue), OR conjunctivitis or conjunctival injection (redness of the eyes), OR extremity findings (eg, erythema [redness] or edema [swelling] of the hands or feet) | |
| Respiratory (eg, pneumonia, ARDS, pulmonary embolism) | Shock | |
| Hematologic (eg, elevated D-dimer, thrombophilia, thrombocytopenia) | Gastrointestinal involvement indicated by abdominal pain, OR vomiting, OR diarrhea | |
| Gastrointestinal (eg, abdominal pain, vomiting, diarrhea, elevated bilirubin, elevated liver enzymes) | Hematologic involvement indicated by platelet count <150 000 cells/μL, OR absolute lymphocyte count (ALC) <1000 cells/μL | |
| Dermatologic (eg, rash, mucocutaneous lesions) | ||
| Neurologic (eg, CVA, aseptic meningitis, encephalopathy, seizure) |
| Criterion . | 2020 CDC MIS-C Case Definition . | CSTE/CDC MIS-C Surveillance Case Definition . |
|---|---|---|
| Patient age | <21 y | <21 y |
| Hospitalization | Clinically severe illness requiring hospitalization | Clinical severity requiring hospitalization or resulting in death |
| No alternative diagnosis | No alternative plausible diagnoses | Absence of a more likely alternative diagnosis |
| Fever | Fever ≥38.0°C for ≥24 h, or report of subjective fever lasting ≥24 h | Subjective or documented fever (temperature ≥38.0°C) |
| Laboratory evidence of systemic inflammation | Including, but not limited to, 1 or more of the following: an elevated C-reactive protein, erythrocyte sedimentation rate, fibrinogen, procalcitonin, d-dimer, ferritin, lactic acid dehydrogenase, or interleukin 6, elevated neutrophils, reduced lymphocytes and low albumin | C-reactive protein ≥3.0 mg/dL (30 mg/L) |
| Evidence of SARS-CoV-2 infection or exposure | 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 wks before the onset of symptoms | Detection of SARS-CoV-2 RNA in a clinical specimen up to 60 d before or during hospitalization, or in a postmortem specimen using a diagnostic molecular amplification test (eg, PCR), OR |
| Detection of SARS-CoV-2-specific antigen in a clinical specimen up to 60 before or during hospitalization, or in a postmortem specimen, OR | ||
| Detection of SARS-CoV-2-specific antibodies in serum, plasma, or whole blood associated with current illness resulting in or during hospitalization, OR | ||
| Close contact with a confirmed or probable case of COVID-19 in the 60 d before hospitalization | ||
| Multisystem involvement | Multisystem (≥2) organ involvement: | New onset manifestations in at least 2 of the following categories: |
| Cardiovascular (eg, shock, elevated troponin and/or BNP, abnormal echocardiogram, arrhythmia) | Cardiac involvement indicated by left ventricular ejection fraction <55%, OR coronary artery dilatation, aneurysm, or ectasia, OR troponin elevated to greater than laboratory normal range, or indicated as elevated in a clinical note | |
| Renal (eg, acute kidney injury, renal failure) | Mucocutaneous involvement indicated by rash, OR inflammation of the oral mucosa (eg, mucosal erythema or swelling, drying, or fissuring of the lips, strawberry tongue), OR conjunctivitis or conjunctival injection (redness of the eyes), OR extremity findings (eg, erythema [redness] or edema [swelling] of the hands or feet) | |
| Respiratory (eg, pneumonia, ARDS, pulmonary embolism) | Shock | |
| Hematologic (eg, elevated D-dimer, thrombophilia, thrombocytopenia) | Gastrointestinal involvement indicated by abdominal pain, OR vomiting, OR diarrhea | |
| Gastrointestinal (eg, abdominal pain, vomiting, diarrhea, elevated bilirubin, elevated liver enzymes) | Hematologic involvement indicated by platelet count <150 000 cells/μL, OR absolute lymphocyte count (ALC) <1000 cells/μL | |
| Dermatologic (eg, rash, mucocutaneous lesions) | ||
| Neurologic (eg, CVA, aseptic meningitis, encephalopathy, seizure) |