Background: Although symptoms and signs MESHD of COVID-19 ( Coronavirus disease MESHD 2019) in children TRANS are milder than adults TRANS, there are reports of more severe cases which was defined as pediatric inflammatory multisystem syndrome MESHD (PIMS). The purpose of this report is to describe possible association between COVID-19 and PIMS in children TRANS. Methods: From 28 March to 24 June 2020, 10 febrile children TRANS were admitted with COVID-19 infection MESHD showing characteristics of PIMS in a tertiary hospital in the north of Iran. Demographic and clinical characteristics, laboratory and imaging findings and therapeutic modalities were recorded and analysed. Results: The mean age TRANS of patients was 5.37±3.9 years (13 months to 12 years). Six of them were boy. Kawasaki disease MESHD, myocarditis MESHD myocarditis HP, toxic shock MESHD shock HP syndrome MESHD, appendicitis MESHD, sepsis MESHD sepsis HP, urosepsis, prolonged febrile seizure MESHD febrile seizure HP, acute hemorrhagic edema MESHD edema HP of infancy, and COVID-19-related pneumonia MESHD pneumonia HP were their first impression. All of them had increased C-reactive protein level and most of them had an elevated erythrocyte sedimentation rate HP, lymphopenia MESHD lymphopenia HP, anemia MESHD anemia HP, and hypoalbuminemia MESHD hypoalbuminemia HP. Some of them had thrombocytopenia MESHD thrombocytopenia HP. Six of them were serologically or polymerase chain reaction positive for COVID-19, and 4 of them were diagnosed as COVID-19 just by chest computed tomography scan. Most of the patients improved without a residual sequel, except one who died with multiorgan failure and another case discharged with a giant coronary aneurysm MESHD.Conclusion: Children TRANS with COVID-19 may present symptoms similar to Kawasaki disease MESHD and inflammatory syndromes MESHD. PIMS should be considered in children TRANS with fever MESHD fever HP and rash, seizure MESHD seizure HP, cough MESHD cough HP, tachypnea MESHD tachypnea HP, and gastrointestinal symptoms such as vomiting MESHD vomiting HP, diarrhea MESHD diarrhea HP, and abdominal pain MESHD abdominal pain HP.