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Protocol - Long COVID - Multisystem Inflammatory Syndrome - Child

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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

Available

Personnel and Training Required

None

Equipment Needs

None

Requirements
Requirement CategoryRequired
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
StandardNameIDSource
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 IDVariable DescriptiondbGaP Mapping
PX992501_Multisystem_Inflammatory_Syndrome_Abdominal_Pain
PX992501150000 Abdominal pain N/A
PX992501_Multisystem_Inflammatory_Syndrome_Any_Household_Member_Confirmed_COVID_Past_4_Weeks
PX992501430000 Any household member (or other contact) with more
confirmed COVID-19 in previous 4 weeks? show less
N/A
PX992501_Multisystem_Inflammatory_Syndrome_Bilateral_Conjunctivitis
PX992501030000 Bilateral conjunctivitis N/A
PX992501_Multisystem_Inflammatory_Syndrome_Bleeding
PX992501390000 Bleeding (haemorrhage) N/A
PX992501_Multisystem_Inflammatory_Syndrome_Bleeding_Site
PX992501390100 If yes, specify site N/A
PX992501_Multisystem_Inflammatory_Syndrome_Cervical_Lymphyadenopathy
PX992501280000 Cervical lymphadenopathy N/A
PX992501_Multisystem_Inflammatory_Syndrome_Chest_Pain
PX992501120000 Chest pain N/A
PX992501_Multisystem_Inflammatory_Syndrome_Cold_Hands_Feet
PX992501100000 Cold hands/feet N/A
PX992501_Multisystem_Inflammatory_Syndrome_Cough
PX992501180000 Cough N/A
PX992501_Multisystem_Inflammatory_Syndrome_Diarrhoea
PX992501160000 Diarrhoea N/A
PX992501_Multisystem_Inflammatory_Syndrome_Family_History_Kawasaki_Disease
PX992501450000 Family history of Kawasaki disease? N/A
PX992501_Multisystem_Inflammatory_Syndrome_Fatigue_Malaise
PX992501190000 Fatigue/malaise N/A
PX992501_Multisystem_Inflammatory_Syndrome_Fever
PX992501010000 Fever (measured or self-reported) N/A
PX992501_Multisystem_Inflammatory_Syndrome_Fever_Duration
PX992501010100 Duration of fever N/A
PX992501_Multisystem_Inflammatory_Syndrome_Headache
PX992501230000 Headache N/A
PX992501_Multisystem_Inflammatory_Syndrome_History_COVID_Infection_Previous_4_Weeks_Prior_Illness
PX992501410000 History of COVID-19 infection in the more
previous 4 weeks prior to current illness? show less
N/A
PX992501_Multisystem_Inflammatory_Syndrome_History_Respiratory_Infection_Previous_4_Weeks_Prior_Illness
PX992501420000 History of any respiratory infection in the more
previous 4 weeks prior to current illness? show less
N/A
PX992501_Multisystem_Inflammatory_Syndrome_Hospital_Admit_Past_3_Months
PX992501400000 Has the child been admitted to hospital in more
the last 3 months? show less
N/A
PX992501_Multisystem_Inflammatory_Syndrome_Hospital_Admit_Past_3_Months_Discharge_Date
PX992501400100 If yes, date of discharge from hospital N/A
PX992501_Multisystem_Inflammatory_Syndrome_Hospital_Admit_Past_3_Months_Related_Similar_Problems
PX992501400200 If yes, was it related to this illness more
episode or for the same or similar problems? show less
N/A
PX992501_Multisystem_Inflammatory_Syndrome_Hypogeusia
PX992501350000 Hypogeusia (loss of taste) N/A
PX992501_Multisystem_Inflammatory_Syndrome_Hyposmia_Anosmia
PX992501330000 Hyposmia/anosmia (loss of smell) N/A
PX992501_Multisystem_Inflammatory_Syndrome_Hypotension
PX992501060000 Hypotension (age-appropriate) N/A
PX992501_Multisystem_Inflammatory_Syndrome_Hypotonia
PX992501250000 Hypotonia/floppiness N/A
PX992501_Multisystem_Inflammatory_Syndrome_Irritability
PX992501290000 Irritability N/A
PX992501_Multisystem_Inflammatory_Syndrome_Joint_Pain
PX992501300000 Joint pain (arthralgia) N/A
PX992501_Multisystem_Inflammatory_Syndrome_Muscle_Aches
PX992501320000 Muscle aches N/A
PX992501_Multisystem_Inflammatory_Syndrome_Not_Able_Drink
PX992501370000 Not able to drink N/A
PX992501_Multisystem_Inflammatory_Syndrome_Oral_Mucosal_Sign
PX992501040000 Oral mucosal inflammation signs N/A
PX992501_Multisystem_Inflammatory_Syndrome_Other
PX992501380000 Other? Specify N/A
PX992501_Multisystem_Inflammatory_Syndrome_Pale_Mottled_Skin
PX992501090000 Pale/mottled skin N/A
PX992501_Multisystem_Inflammatory_Syndrome_Paralysis
PX992501270000 Paralysis N/A
PX992501_Multisystem_Inflammatory_Syndrome_Past_History_Kawasaki_Disease
PX992501440000 Past history of Kawasaki disease? N/A
PX992501_Multisystem_Inflammatory_Syndrome_Peripheral_Cutaneous_Sign
PX992501050000 Peripheral cutaneous inflammation signs more
(hands or feet) show less
N/A
PX992501_Multisystem_Inflammatory_Syndrome_Photophobia
PX992501310000 Photophobia N/A
PX992501_Multisystem_Inflammatory_Syndrome_Prolonged_Capillary_Refill_Time
PX992501080000 Prolonged capillary refill time N/A
PX992501_Multisystem_Inflammatory_Syndrome_Rash
PX992501020000 Rash N/A
PX992501_Multisystem_Inflammatory_Syndrome_Rash_Type
PX992501020100 If yes type of rash N/A
PX992501_Multisystem_Inflammatory_Syndrome_Respiratory_Distress
PX992501140000 Respiratory distress N/A
PX992501_Multisystem_Inflammatory_Syndrome_Runny_Nose
PX992501220000 Runny nose N/A
PX992501_Multisystem_Inflammatory_Syndrome_Seizures
PX992501210000 Seizures N/A
PX992501_Multisystem_Inflammatory_Syndrome_Skin_Ulcers
PX992501340000 Skin ulcers N/A
PX992501_Multisystem_Inflammatory_Syndrome_Sore_Throat
PX992501200000 Sore throat N/A
PX992501_Multisystem_Inflammatory_Syndrome_Stiff_Neck
PX992501360000 Stiff neck N/A
PX992501_Multisystem_Inflammatory_Syndrome_Swollen_Joints
PX992501260000 Swollen joints N/A
PX992501_Multisystem_Inflammatory_Syndrome_Tachycardia
PX992501070000 Tachycardia (age-appropriate) N/A
PX992501_Multisystem_Inflammatory_Syndrome_Tachypnoea
PX992501130000 Tachypnoea (age-appropriate) N/A
PX992501_Multisystem_Inflammatory_Syndrome_Urinary_Output
PX992501110000 Urinary output < 2 mL/kg/hr N/A
PX992501_Multisystem_Inflammatory_Syndrome_Vomiting
PX992501170000 Vomiting N/A
PX992501_Multisystem_Inflammatory_Syndrome_Wheezing
PX992501240000 Wheezing N/A
Long COVID
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.