Diagnosis of MIS-C in Febrile Children

The recent emergence of SARS-CoV-2 and resultant pandemic of COVID-19 disease has overwhelmed global health systems and led to over 200,000 American deaths to date. While initial reports suggested that SARS-CoV-2 infection in children was generally benign, a novel post-inflammatory syndrome known as multisystem inflammatory syndrome in children (MIS-C) has now been described. MIS-C in children is characterized by fever, systemic inflammation, and end-organ involvement, and the majority of patients are IgG seropositive for SARS-CoV-2. Because the clinical features of MIS-C overlap with other infections and inflammatory disorders, new strategies for diagnosis of MIS-C in febrile children are urgently needed. The immediate objective of this study was to determine the reproducible changes in breath, urine, and salivary volatile composition in children diagnosed with MIS-C. These discovery studies were integrated with clinical and immunological profiling to develop and validate a novel and much-needed MIS-C diagnostic, which was expected to have a major impact on care of febrile children. The long-term goal of this study was to develop a diagnostic strategy to distinguish children with MIS-C from children with other causes of fever.