Protocol - Long COVID - Multisystem Inflammatory Syndrome - Child
Description
This protocol helps better describe and understand the patient experience and recovery of those with confirmed or suspected COVID-19, with a specific emphasis on MIS and body inflammation in children and adolescents.
Specific Instructions
None
Protocol
POSSIBLE SIGNS AND SYMPTOMS OF MULTISYSTEM INFLAMMATORY SYNDROME
(complete when MIS is first suspected)
Fever (measured or self-reported)
[ ] Yes
[ ] No
[ ] Unknown
Duration of fever ___ days
Rash
[ ] Yes
[ ] No
[ ] Unknown
If yes type of rash _____________________
Bilateral conjunctivitis
[ ] Yes, purulent
[ ] Yes, non-purulent
[ ] No
[ ] Unknown
Oral mucosal inflammation signs
[ ] Yes
[ ] No
[ ] Unknown
Peripheral cutaneous inflammation signs (hands or feet)
[ ] Yes
[ ] No
[ ] Unknown
Hypotension (age-appropriate)
[ ] Yes
[ ] No
[ ] Unknown
Tachycardia (age-appropriate)
[ ] Yes
[ ] No
[ ] Unknown
Prolonged capillary refill time
[ ] Yes
[ ] No
[ ] Unknown
Pale/mottled skin
[ ] Yes
[ ] No
[ ] Unknown
Cold hands/feet
[ ] Yes
[ ] No
[ ] Unknown
Urinary output < 2 mL/kg/hr
[ ] Yes
[ ] No
[ ] Unknown
Chest pain
[ ] Yes
[ ] No
[ ] Unknown
Tachypnoea (age-appropriate)
[ ] Yes
[ ] No
[ ] Unknown
Respiratory distress
[ ] Yes
[ ] No
[ ] Unknown
Abdominal pain
[ ] Yes
[ ] No
[ ] Unknown
Diarrhoea
[ ] Yes
[ ] No
[ ] Unknown
Vomiting
[ ] Yes
[ ] No
[ ] Unknown
OTHER SIGNS AND SYMPTOMS (complete when MIS is first suspected)
Cough
[ ] Yes
[ ] No
[ ] Unknown
Fatigue/malaise
[ ] Yes
[ ] No
[ ] Unknown
Sore throat
[ ] Yes
[ ] No
[ ] Unknown
Seizures
[ ] Yes
[ ] No
[ ] Unknown
Runny nose
[ ] Yes
[ ] No
[ ] Unknown
Headache
[ ] Yes
[ ] No
[ ] Unknown
Wheezing
[ ] Yes
[ ] No
[ ] Unknown
Hypotonia/floppiness
[ ] Yes
[ ] No
[ ] Unknown
Swollen joints
[ ] Yes
[ ] No
[ ] Unknown
Paralysis
[ ] Yes
[ ] No
[ ] Unknown
Cervical lymphadenopathy
[ ] Yes
[ ] No
[ ] Unknown
Irritability
[ ] Yes
[ ] No
[ ] Unknown
Joint pain (arthralgia)
[ ] Yes
[ ] No
[ ] Unknown
Photophobia
[ ] Yes
[ ] No
[ ] Unknown
Muscle aches
[ ] Yes
[ ] No
[ ] Unknown
Hyposmia/anosmia (loss of smell)
[ ] Yes
[ ] No
[ ] Unknown
Skin ulcers
[ ] Yes
[ ] No
[ ] Unknown
Hypogeusia (loss of taste)
[ ] Yes
[ ] No
[ ] Unknown
Stiff neck
[ ] Yes
[ ] No
[ ] Unknown
Not able to drink
[ ] Yes
[ ] No
[ ] Unknown
Other? Specify ___________________
Bleeding (haemorrhage)
[ ] Yes
[ ] No
[ ] Unknown
If yes, specify site _____________________________________
RECENT HISTORY
Has the child been admitted to hospital in the last 3 months?
[ ] Yes
[ ] No
[ ] Unknown
If yes, date of discharge from hospital [_D_][_D_]/[_M_][_M_]/[_2_][_0_][_Y_][_Y_]
If yes, was it related to this illness episode or for the same or similar problems?
[ ] Yes
[ ] No
[ ] Unknown
History of COVID-19 infection in the previous 4 weeks prior to current illness?
[ ] Yes - Lab confirmed
[ ] Yes - Clinically diagnosed
[ ] No
[ ] Unknown
History of any respiratory infection in the previous 4 weeks prior to current illness?
[ ] Yes
[ ] No
[ ] Unknown
Any household member (or other contact) with confirmed COVID-19 in previous 4 weeks?
[ ] Yes
[ ] No
[ ] Unknown
Past history of Kawasaki disease?
[ ] Yes
[ ] No
[ ] Unknown
Family history of Kawasaki disease?
[ ] Yes
[ ] No
[ ] Unknown
Availability
Personnel and Training Required
None
Equipment Needs
None
Requirements
| Requirement Category | Required |
|---|---|
| Major equipment | No |
| Specialized training | No |
| Specialized requirements for biospecimen collection | No |
| Average time of greater than 15 minutes in an unaffected individual | No |
Mode of Administration
Self-administered questionnaire
Lifestage
Child, Adolescent, Adult
Participants
Children and Adolescents aged <21 years old
Selection Rationale
PhenX used input from the PhenX Steering Committee to enable rapid response and release of COVID-19 related protocols in the Toolkit.
Language
English
Standards
| Standard | Name | ID | Source |
|---|
Derived Variables
None
Process and Review
Not Applicable
Protocol Name from Source
Global COVID-19 Clinical Platform: Case Report Form for Suspected Cases of Multisystem Inflammatory Syndrome (MIS) in Children and Adolescents Temporally Related to COVID-19
Source
Global COVID-19 Clinical Platform: Case Report Form for Suspected Cases of Multisystem Inflammatory Syndrome (MIS) in Children and Adolescents Temporally Related to COVID-19. (2020). World Health Organization, Questions 1c, 1d and 1e.
General References
None
Protocol ID
992501
Variables
Export Variables| Variable Name | Variable ID | Variable Description | dbGaP Mapping |
|---|
Measure Name
Long COVID - Multisystem Inflammatory Syndrome
Release Date
May 26, 2023
Definition
This is a measure recording suspected cases of Multisystem Inflammatory Syndrome (MIS) in children and adolescents temporally related to COVID-19.
Purpose
Multisystem inflammatory syndrome (MIS) can affect children (MIS-C) and adults (MIS-A). MIS is a rare but serious condition associated with COVID-19 in which different body parts become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. Use of this measure helps with understanding people’s experience with COVID-19 and implications of Long COVID.
Keywords
long covid - multisystem inflammatory syndrome - child, coronavirus, COVID-19, health history, CDC, COVID-19 infection
Measure Protocols
| Protocol ID | Protocol Name |
|---|---|
| 992501 | Long COVID - Multisystem Inflammatory Syndrome - Child |
Publications
There are no publications listed for this protocol.