text: Post COVID 19 multisystem inflammatory syndrome in children The effect of acute coronavirus disease 2019 COVID 19 on morbidity and mortality in children has been relatively small If a child presents to my office with persistent fever and systemic hyperinflammation but no known exposure to COVID 19 how likely are they to have multisystem inflammatory syndrome in children MIS C What is currently known about MIS C and what is the prognosis for children affected by it Amid the COVID 19 pandemic the emergence of a novel condition presents yet another challenge to clinicians public health professionals and the pediatric population Multisystem inflammatory syndrome in children is a rare but potentially severe condition seen in children with evidence of COVID 19 approximately 2 to 6 weeks before symptom onset Common signs and symptoms include persistent fever systemic hyperinflammation gastrointestinal symptoms eg abdominal pain vomiting diarrhea mucocutaneous changes eg rash conjunctivitis headache or cardiac dysfunction As many children present as asymptomatic or with mild symptoms of COVID 19 the development of MIS C can seem sudden and surprising to families and providers Although children with MIS C usually require hospitalization the outcomes are largely favourable with prompt recognition and intense therapy 