Introduction: We report an eight-case series of coronavirus disease 2019 (COVID-19)-related multisystem inflammatory syndrome in children (MIS-C). Methods: Children who tested positive for COVID-19, met the MIS-C criteria of the World Health Organization (WHO), and were hospitalized at a tertiary hospital in Riyadh from September to December 2021 were identified and their clinical data reviewed. Results: The age at diagnosis is between 4 to 13 years old. Fever, decreased oral intake, gastroenteritis, and abdominal pain were the most common symptoms. All cases showed hyperinflammation with high C-reactive protein, erythrocyte sedimentation rate, ferritin levels, and deranged coagulation profiles. Most of the cases had elevated B-type natriuretic peptide (75%) and troponin (100%) levels. However, two cases had cardiovascular involvement. Two patients presented with acute respiratory distress syndrome and required mechanical ventilation. The mean hospital stay was 13.1 days, with seven patients initially requiring intensive care management for ionotropic support. Most cases required broad-spectrum antibiotics, intravenous steroids, intravenous immunoglobulin, and aspirin. All patients recovered and were discharged from the hospital in good clinical condition. Conclusion: Children with COVID-19 are at risk of developing MIS-C. Practitioners must have a high index of suspicion for its diagnosis and should start treatment as soon as possible to prevent unfavorable outcomes.
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