text: Comparison of Clinical Features and Outcome of Dengue Fever and Multisystem Inflammatory Syndrome in Children Associated With COVID 19 MIS C To identify clinical and laboratory features that differentiate dengue fever patients from MIS C patients and determine their outcomes This comparative cross sectional study was done at a tertiary care teaching institute We enrolled all hospitalized children aged 1 month 18 years and diagnosed with either MIS C and or dengue fever according to WHO criteria between June and December 2020 Clinical and laboratory features and outcomes were recorded on a structured proforma During the study period 34 cases of MIS C and 83 cases of Dengue fever were enrolled Mean age of MIS C cases male 86 3 was 7 89 4 61 years MIS C with shock was seen in 15 cases 44 MIS C without shock in 17 cases 50 and Kawasaki disease like presentation in 2 cases 6 Patients of MIS C were younger as compared to dengue fever P 0 002 Abdominal pain and erythematous rash were more common in dengue fever Of the inflammatory markers mean C reactive protein was higher in MIS C patients 100 2 85 1 vs 16 9 29 3 mg dL P 0 001 In contrast serum ferritin levels were higher in dengue fever patients P 0 03 Mean hospital stay patient days was longer in MIS C compared to dengue fever 8 6 vs 6 5 days P 0 014 Clinical and laboratory features can give important clues to differentiate dengue fever and MIS C and help initiate specific treatment 