Introduction: Multisystem inflammatory syndrome in children (MIS-C) is the dangerous complication in the pediatrics population associated with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). It leads to the injury of several organs and impairment of their function. Treatment protocols have been placed to avoid the long-term consequences of this syndrome which may be severe enough to cause death of the affected patient.

Case description: A 50 days old boy with no previous medical conditions presented to the hospital with respiratory distress and had a negative reverse transcription polymerase chain reaction (RT-PCR) test for novel coronavirus and his family denied contact with a COVID-19 infected individual. The patient clinical status deteriorated and was not responding to antibiotics and nebulizers. This raised our suspicion for MIS-C so a SARS-CoV-2 serology was performed and were found out to be positive. Treatment started but the patient deteriorated rapidly and ended up intubated on mechanical ventilation then passed away after a cardio-pulmonary arrest.

Discussion: During the COVID-19 pandemic, respiratory complaints must be considered to be associated with coronavirus infection and must not be ruled out by just performing a PCR test from a nasopharyngeal sample. Knowing that MIS-C usually do not appear during the acute phase of coronavirus infection but rather after the resolving of the infection.

Conclusion: This case raises the necessity of performing serology for SARS-CoV-2 for a patient presenting with respiratory complaints and with non-resolving multi-organ inflammatory injury. Also, no age group can be considered safe and protected from complications of coronavirus infection. This is why serious precautions must be applied when a suspected or infected individual is dealing with other people.

Keywords: MIS-C; SARS-CoV-2; Pediatrics; Serology