BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C), also known as 
pediatric inflammatory multisystem syndrome, is a new dangerous childhood 
disease that is temporally associated with coronavirus disease 2019 (COVID-19). 
We aimed to describe the typical presentation and outcomes of children diagnosed 
with this hyperinflammatory condition.
METHODS: We conducted a systematic review to communicate the clinical signs and 
symptoms, laboratory findings, imaging results, and outcomes of individuals with 
MIS-C. We searched four medical databases to encompass studies characterizing 
MIS-C from January 1st, 2020 to July 25th, 2020. Two independent authors 
screened articles, extracted data, and assessed risk of bias. This review was 
registered with PROSPERO CRD42020191515.
FINDINGS: Our search yielded 39 observational studies (n = 662 patients). While 
71·0% of children (n = 470) were admitted to the intensive care unit, only 11 
deaths (1·7%) were reported. Average length of hospital stay was 7·9 ± 0·6 days. 
Fever (100%, n = 662), abdominal pain or diarrhea (73·7%, n = 488), and vomiting 
(68·3%, n = 452) were the most common clinical presentation. Serum inflammatory, 
coagulative, and cardiac markers were considerably abnormal. Mechanical 
ventilation and extracorporeal membrane oxygenation were necessary in 22·2% 
(n = 147) and 4·4% (n = 29) of patients, respectively. An abnormal 
echocardiograph was observed in 314 of 581 individuals (54·0%) with depressed 
ejection fraction (45·1%, n = 262 of 581) comprising the most common aberrancy.
INTERPRETATION: Multisystem inflammatory syndrome is a new pediatric disease 
associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 
that is dangerous and potentially lethal. With prompt recognition and medical 
attention, most children will survive but the long-term outcomes from this 
condition are presently unknown.
FUNDING: Parker B. Francis and pilot grant from 2R25-HL126140. Funding agencies 
had no involvement in the study.