We describe six teenagers presenting with fever and severe abdominal
symptoms admitted with concerns for multisystem inflammatory syndrome in
children (MIS-C). Laboratory evaluation revealed elevated markers of
inflammation, lymphopenia, and increased d-dimers. Imaging studies
revealed multifocal airspace disease and ground-glass opacities.
SARS-CoV-2 PCR and serologies were negative. All patients reported a
history of vaping, prompting E-cigarette, or vaping, product
use-associated lung injury (EVALI) diagnosis. MIS-C has overlapping
clinical and laboratory features highlighting the added challenge of
diagnosing EVALI during the COVID-19 pandemic.