Introduction
Coronavirus disease 2019 (COVID-19) was thought to largely spare children until clinicians in the United Kingdom reported a cluster of children with fever and hyperinflammation in late April 20201. Similar reports from Italy, France, and the United States led the Centers for Disease Prevention and Control (CDC) to define this illness as Multisystem Inflammatory Syndrome in children (MIS-C) (CDC). The case definition of MIS-C includes the presence of fever, laboratory evidence of inflammation, multisystem organ involvement, and evidence of SARS-CoV-2 infection or an epidemiologic link to a person with COVID-192. The broad case definition and wide spectrum of clinical presentations, observed with MIS-C, coupled with lack of pathognomonic signs and diagnostic tests have posed new challenges in the evaluation of children presenting with fever and elevated inflammatory markers due to the risk of serious and life-threatening illnesses that must be considered in these patients.
In this report, we describe six patients admitted to the hospital with concerns for MIS-C who were later diagnosed with EVALI.