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Recommendations are also provided for children with hyperinflammation during COVID\u201019, the acute, infectious phase of SARS\u2013CoV\u20102 infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Task Force is composed of 9 pediatric rheumatologists and 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 anonymous voting and webinar discussion. 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). Consensus was rated as low, moderate, or high based on dispersion of the votes. Approved guidance statements were those that were classified as appropriate with moderate or high levels of consensus, which were prespecified before voting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The guidance was approved in June 2020 and updated in November 2020 and October 2021, and consists of 41 final guidance statements accompanied by flow diagrams depicting the diagnostic pathway for MIS\u2010C and recommendations for initial immunomodulatory treatment of MIS\u2010C.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our understanding of SARS\u2013CoV\u20102\u2013related syndromes in the pediatric population continues to evolve. This guidance document reflects currently available evidence coupled with expert opinion, and will be revised as further evidence becomes available.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/art.42062","type":"journal-article","created":{"date-parts":[[2022,2,3]],"date-time":"2022-02-03T21:48:52Z","timestamp":1643924932000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":247,"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 3"],"prefix":"10.1002","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0242-4029","authenticated-orcid":false,"given":"Lauren A.","family":"Henderson","sequence":"first","affiliation":[{"name":"Boston Children's Hospital and Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott W.","family":"Canna","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin G.","family":"Friedman","sequence":"additional","affiliation":[{"name":"Boston Children's 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"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8452-9937","authenticated-orcid":false,"given":"Sivia K.","family":"Lapidus","sequence":"additional","affiliation":[{"name":"Joseph M. 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