text: Similarities and differences between multiple inflammatory syndrome in children associated with COVID 19 and Kawasaki disease clinical presentations diagnosis and treatment Severe acute respiratory syndrome coronavirus 2 SARS CoV 2 infection has been spreading rapidly around the world while multisystem inflammatory syndrome in children MIS C is a new type of syndrome that has now been reported in many countries Similar and different characteristics between KD and MIS C have been reported in a variety of literature We aimed to focus on reviewing clinical presentations diagnosis and treatment of KD and MIS C We searched articles in the electronic databases including the Cochrane Library database EMBASE and MEDLINE with the keywords multiple inflammatory syndrome and or COVID 19 and or Kawasaki disease and children Main presentations of MIS C and KD include fever rashes mucous membrane involvement conjunctivitis hands and feet erythema edema and cervical lymphadenopathy However compared with the highest incidence of KD among some Asian countries MIS C is common among Black and Hispanic children MIS C is common in older children and teenagers whereas classic KD is common in children under five years of age Gastrointestinal symptoms shock and coagulopathy are common in MIS C patients but are not common in classic KD Cardiac manifestations are more common than KD including myocarditis with cardiac dysfunction and coronary artery dilation or aneurysms Severe cases in MIS C present with vasodilated or cardiogenic shock that requires fluid resuscitation muscular support and even mechanical ventilation and extracorporeal membrane oxygenation ECMO whereas KD rarely presents with these manifestations and requires these treatments Increased serum ferritin leukopenia lymphopenia and thrombocytopenia are common in MIS C However thrombocytosis is a characteristic feature of KD Intravenous immunoglobulin IVIG and moderate high dose aspirin are still a standard recommended treatment for KD In addition to the above mentioned medications steroids and biological drugs are frequently used in patients with MIS C Most of the children with KD have a good prognosis however the long term clinical outcomes of MIS C are not clear The overall presentation and treatment of MIS C appear to overlap with KD However there are still great differences between the syndromes and it is controversial to say whether MIS C is a new entity or is a severe type of KD 