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Long-Term Outcomes of Multisystem Inflammatory Syndrome in Children up to 4.5 Years After COVID-19

Shiv Mehrotra-Varma1, Hien Quang Nguyen1, Sonya Henry1

  • 1Department of Radiology, Montefiore Health System and Albert Einstein College of Medicine, Bronx, New York.

Pediatrics
|June 9, 2026
PubMed

Insights

Multisystem inflammatory syndrome in children (MIS-C) following COVID-19 leads to long-term health issues affecting multiple organ systems. These persistent complications underscore the need for ongoing medical monitoring and care for affected children.

Area of Science:

  • Pediatric infectious diseases
  • Post-viral syndromes
  • Public health

Background:

  • Multisystem inflammatory syndrome in children (MIS-C) is a severe post-COVID-19 complication.
  • The long-term health consequences of MIS-C are not well understood.

Purpose of the Study:

  • To investigate the long-term risks of multisystem dysfunction in children with MIS-C compared to those without.
  • To identify factors influencing persistent morbidity after MIS-C.

Main Methods:

  • A retrospective cohort study involving 173 children with MIS-C and 14,190 controls up to 4.5 years post-COVID-19.
  • Propensity score matching and Cox regression analysis were used to compare outcomes.
  • Outcomes included cardiovascular, gastrointestinal, respiratory, neurological, and renal disorders.

Main Results:

  • Patients with MIS-C had significantly higher risks of cardiovascular, hypertension, gastrointestinal, respiratory, and neurological disorders.
  • Preexisting hypertension, age, and diabetes were associated with increased risks of specific complications.
  • Kaplan-Meier analysis revealed persistent risks for all evaluated outcomes in the MIS-C group.

Conclusions:

  • MIS-C is linked to widespread and persistent multisystem morbidity years after acute COVID-19.
  • Structured long-term follow-up, including monitoring of blood pressure, neurological, cardiovascular, and renal health, is crucial.
  • Coordinated multidisciplinary care is recommended for children with a history of MIS-C.
Abstract

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