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The task force was composed of 9 pediatric rheumatologists, 2 adult rheumatologists, 2 pediatric cardiologists, 2 pediatric infectious disease specialists, and 1 pediatric critical care physician. Preliminary statements addressing clinical questions related to MIS\u2010C and hyperinflammation in COVID\u201019 were developed based on evidence reports. Consensus was built through a modified Delphi process that involved 2 rounds of anonymous voting and 2 webinars. A 9\u2010point scale was used to determine the appropriateness of each statement (median scores of 1\u20133 for inappropriate, 4\u20136 for uncertain, and 7\u20139 for appropriate), and consensus was rated as low, moderate, or high based on dispersion of the votes along the numeric scale. Approved guidance statements were those that were classified as appropriate with moderate or high levels of consensus, as prespecified prior to voting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The ACR task force approved a total of 128 guidance statements addressing the management of MIS\u2010C and hyperinflammation in pediatric COVID\u201019. These statements were refined into 40 final clinical guidance statements, accompanied by a flow diagram depicting the diagnostic pathway for MIS\u2010C.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our understanding of SARS\u2013CoV\u20102\u2013related syndromes in the pediatric population continues to evolve. The guidance provided in this \u201cliving document\u201d reflects currently available evidence, coupled with expert opinion, and will be revised as further evidence becomes available.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.41454","type":"journal-article","created":{"date-parts":[[2020,7,24]],"date-time":"2020-07-24T01:29:42Z","timestamp":1595554182000},"page":"1791-1805","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":327,"title":["American College of Rheumatology Clinical Guidance for Multisystem Inflammatory Syndrome in Children Associated With SARS\u2013CoV\u20102 and Hyperinflammation in Pediatric COVID\u201019: Version 1"],"prefix":"10.1002","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0242-4029","authenticated-orcid":false,"given":"Lauren A.","family":"Henderson","sequence":"first","affiliation":[{"name":"Boston Children\u2019s Hospital and Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott W.","family":"Canna","sequence":"additional","affiliation":[{"name":"UPMC Children\u2019s Hospital of Pittsburgh and University of Pittsburgh  Pittsburgh Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin G.","family":"Friedman","sequence":"additional","affiliation":[{"name":"Boston Children\u2019s Hospital and Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Gorelik","sequence":"additional","affiliation":[{"name":"Morgan Stanley Children\u2019s Hospital and Columbia University  New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sivia K.","family":"Lapidus","sequence":"additional","affiliation":[{"name":"Joseph M. 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