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
Availability
This protocol is freely available; permission not required for use.
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
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 | |
|---|---|---|---|---|
| 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 | 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 | N/A | ||
| PX992501_Multisystem_Inflammatory_Syndrome_History_Respiratory_Infection_Previous_4_Weeks_Prior_Illness | ||||
| PX992501420000 | History of any respiratory infection in the more | N/A | ||
| PX992501_Multisystem_Inflammatory_Syndrome_Hospital_Admit_Past_3_Months | ||||
| PX992501400000 | Has the child been admitted to hospital in more | 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 | 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 | 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 | ||
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
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.