Age | < 21 years | 0–19 years of age | 0–19 years of age |
Fever | Documented fever (≥ 38°C) | Fever > 3 days | Fever ≥ 38°C at least for 24 hours |
Severity | Illness with clinical severity requiring hospitalization or resulting in death | | Illness with clinical severity requiring hospitalization |
Alternative diagnosis | A more likely alternative diagnosis is not present | No other obvious microbial cause of inflammation, including bacterial sepsis, staphylococcal or streptococcal shock syndromes | No other microbial cause of inflammation, including bacterial sepsis, staphylococcal or streptococcal toxic shock syndrome, or enteroviral myocarditis |
Inflammation | CRP ≥ 3.0 mg/dL | Elevated markers of inflammation such as ESR, CRP, or procalcitonin | Elevated inflammatory markers (ESR, CRP, fibrinogen, procalcitonin, d-dimer, ferritin, LDH, IL-6, or neutrophil)Decreased lymphocyte or albumin |
Organ involvement | New onset manifestations in ≥ 2 of the following categories1) Cardiac involvement1)2) Mucocutaneous involvement2)3) Shock4) Gastrointestinal involvement3)5) Hematologic involvement4) | At least two of the followings1) Cardiac involvement2) Mucocutaneous inflammation3) Hypotension or shock4) Gastrointestinal problems5) Evidence of coagulopathy | Two or more involved organ system1) Cardiac involvement2) Renal involvement3) Pulmonary involvement4) Hematologic involvement5) Gastrointestinal involvement6) Mucocutaneous involvement7) Neurologic involvement |
Epidemiologic linkage with SARS-CoV-2 | Detection of SARS-CoV-2 RNA, SARS-CoV-2 antigen or antibodies up to 60 days prior to or during hospitalization, or in a post-mortem specimenLikely contact with patients with COVID-19 in the 60 days prior | Evidence of COVID-19 (RT-PCR, antigen test, or serology positive)Likely contact with patients with COVID-19 | Evidence of COVID-19 (RT-PCR, antigen test, or serology positive)Likely contact with patients with COVID-19 up to 4 weeks prior |