Most of the reports about severe acute respiratory syndrome coronavirus 2 
(SARS-CoV-2) in children reported mild-to-moderate disease manifestations. 
However, recent reports explored a rare pediatric multisystem syndrome possibly 
associated with SARS-CoV-2 infection termed multisystem inflammatory syndrome in 
children (MIS-C).The study prospectively enrolled 5 patients with clinical and 
laboratory evidence of MIS-C associated with SARS-CoV-2 infection. They were 
admitted to the pediatric intensive care unit (PICU). Their clinical 
presentation, laboratory, and outcome were described.All patients shared similar 
clinical presentations such as persistent documented fever for more than 3 days, 
respiratory symptoms, gastrointestinal involvement, and increased inflammatory 
markers (CRP, ESR, and ferritin). Three patients had concurrent positive 
coronavirus disease 2019 (COVID-19) infection, and the other 2 patients had 
contact with suspected COVID-19 positive patients. They were all managed in the 
PICU and received intravenous immunoglobulin, systemic steroid, and 
hydroxychloroquine. The hospital stays ranged between 3 and 21 days. One patient 
died due to severe multiorgan failures and shock, and the other 4 patients were 
discharged with good conditions.Pediatric patients with SARS-CoV-2 are at risk 
for MIS-C. MIS-C has a spectrum of clinical and laboratory presentations, and 
the clinicians need to have a high index of suspicion for the diagnosis and 
should initiate its early treatment to avoid unfavorable outcomes. Long-term 
follow-up studies will be required to explore any sequelae of MIS-C, precisely 
the cardiovascular complications.