BALTIMORE (WJZ/CNN) — The Maryland Department of Health reports at least four cases, one of which was fatal, of Multisystem Inflammatory Syndrome in Children or MIS-C, the inflammatory syndrome linked to coronavirus.

MIS-C is a severe inflammatory syndrome where pediatric patients present with features similar to Kawasaki disease, according to a national health alert issued last week from the CDC. MIS-C appears to be rare and most children who get COVID-19 will not develop MIS-C, according to the CDC.

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Daryana Dyson, a 15-year-old girl from Baltimore County, is the first reported pediatric death link to COVID-19. County and state officials say Dyson had MIS-C.

“MDH is working with federal, regional, and local health departments to remain updated on this evolving situation and to identify any additional cases of MIS-C in Maryland,” state health officials said in a statement.

Doctors have been tracking the mystery COVID-19 related-illness which first emerged overseas, and then in New York State.

“There are many theories out there as to why this could be happening,” Dr. Kerri Best, a Pediatrician with MedStar Health, said. “Every day we are learning something new about COVID-19, so now that we know about this, it is important to backtrack just to make sure we don’t miss any cases.”

“When this all started, we thought that COVID-19 wasn’t affecting the pediatric population very much,” Dr. Best added. “But now that we see Pediatric Multisystem Inflammatory Syndrome coming up, we are seeing this is impacting the pediatric population.”

Symptoms include, fever, rash, abdominal pain and even vomiting, but that list could be even longer.

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“These children look very ill,” Dr. Rachel Plotnick, a Pediatrician with GBMC, said. “This is an inflammatory response, so your body is kind of going into overdrive, so it’s stimulating it too much and actually at this point trying to attack itself.”

Dr. Plotnick stresses parents will know when something is off.

“If your child is having trouble breathing, their lips are turning blue, they are going into signs of heart failure so they are having trouble breathing, and if a parent notices that, they should call 911,” Dr. Rachel Plotnick said.

The Health Department believes there may be a few other cases of Multisystem Inflammatory Syndrome in Children in the state, but Daryana is the first reported case of a child passing away.

The CDC said it was still gathering information about the cases.

“There is limited information currently available about risk factors, pathogenesis, clinical course, and treatment for MIS-C. CDC is requesting healthcare providers report suspected cases to public health authorities to better characterize this newly recognized condition in the pediatric population.”

The advisory provides a case definition to guide doctors:

  • An individual aged under 21 years presenting with fever, laboratory evidence of inflammation, and evidence of clinically severe illness requiring hospitalization, with multisystem (more than 2) organ involvement (heart, kidney, renal, respiratory, blood, gastrointestinal, dermatologic or neurological); AND
  • No alternative plausible diagnoses; AND
  • Positive for current or recent SARS-CoV-2 infection by RT-PCR, serology, or antigen test; or COVID-19 exposure within the 4 weeks prior to the onset of symptoms
  • Fever above 38.0°C (100.4F) for 24 hours or more
  • Abnormal blood tests including: an elevated C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen, procalcitonin, d-dimer, ferritin, lactic acid dehydrogenase (LDH), or interleukin 6 (IL-6), elevated neutrophils, reduced lymphocytes and low albumin
  • Some individuals may fulfill full or partial criteria for Kawasaki disease but should be reported if they meet the case definition for MIS-C
  • Consider MIS-C in any pediatric death with evidence of SARS-CoV-2 infection
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Read the CDC health alert about MIS-C here:

Ava-joye Burnett