Four children in Los Angeles County diagnosed with a rare inflammatory disease have tested positive for COVID-19 through antibody testing, officials said Monday.

The county is investigating an additional 21 possible cases of the multisystem inflammatory syndrome associated with the illness, County Public Health Director Barbara Ferrer said. The nearly two dozen cases have been identified since March 1 and are under investigation.

“There are no reported deaths. But as people have noted, this is a very serious illness — although very rare in children,” Ferrer said.

Three of the 25 children who have tested positive for the disease have required admission to a pediatric intensive care unit.

The condition is referred to as both MIS-C (multisystem inflammatory syndrome) and PIMS — pediatric inflammatory multisystem syndrome.

The disease causes inflammation and swelling around the blood vessels, symptoms similar to Kawasaki disease. The Centers for Disease Control and Prevention has previously reported a possible link between the novel coronavirus and the syndrome.

Doctors in the United Kingdom, Los Angeles, New York and a handful of other areas have previously identified the condition among children who tested positive for the coronavirus, including three patients at Children’s Hospital Los Angeles who displayed symptoms of the syndrome earlier this month and tested positive for the virus.

County officials are working with hospitals to identify any additional cases.

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