Case 2 was a 14 year old child presenting at the emergency room with 3 days of fever > 39°C, muscle pain, cough, sore throat, headache and fatigue. The girl’s father had suffered from fever and respiratory symptoms after contact with multiple COVID-19 patients 4 weeks earlier. On day 4 after symptom onset, there was a clinical deterioration to refractory shock and multi-organ failure with hypotension and respiratory and cardiac failure. Lab findings showed thrombopenia (89,000/µL, ref. 154,000–452,000/µL), lymphopenia (162/µL, ref. 1,500–6,500/µL), normal neutrophil count (7,564/µL, ref. 2,500–8,000), normal eosinophil count (283/µL, ref. 100–500/µL), low basophil count (0/µL, ref. 10–100/µL), elevated D-dimers (4,420 ng/mL, ref. <500 ng/mL) and high C-reactive protein (308 mg/L, ref. <5 mg/L). Chest CT did not show signs of viral pneumonia. Echocardiography revealed decreased left ventricular function. She responded well to supportive therapy and corticosteroid treatment. Throat swabs on day 3 and 5 after symptom onset were negative for SARS-CoV-2 with RT-PCR [6]. Serology on day 8 after symptom onset was negative for IgM but positive for IgG (Prima Professional®). She was diagnosed with pediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS-TS).