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Clinical Implications of Hematologic and Hemostatic Abnormalities in Children With COVID-19

Rachel Leeman1, Jamie Shoag1,2, Michael Borchetta1,3

  • 1Holtz Children's Hospital, Jackson Memorial Medical Center.

Journal of Pediatric Hematology/Oncology
|April 30, 2021
PubMed

Insights

In pediatric Coronavirus Disease 2019 patients, leukopenia and thrombocytopenia indicate increased disease severity. Elevated D-dimer and prolonged prothrombin time were not associated with severe complications in this age group.

Area of Science:

  • Hematology
  • Infectious Diseases
  • Pediatrics

Background:

  • Hematologic and hemostatic abnormalities are linked to poor outcomes in adult COVID-19.
  • The prognostic value of these markers in pediatric COVID-19 is not well-established.

Purpose of the Study:

  • To investigate the prognostic significance of hematologic and hemostatic derangements in pediatric patients with acute Coronavirus Disease 2019.

Main Methods:

  • Retrospective cohort study.
  • Inclusion of patients younger than 22 years admitted for acute COVID-19.
  • Analysis of hematologic (leukopenia, thrombocytopenia) and hemostatic (D-dimer, prothrombin time) markers.

Main Results:

  • Leukopenia and thrombocytopenia were identified as independent predictors of disease severity.
  • Most pediatric patients presented with elevated D-dimer or prolonged prothrombin time.
  • These hemostatic markers did not correlate with severe clinical complications.

Conclusions:

  • Leukopenia and thrombocytopenia are significant indicators of severity in pediatric COVID-19.
  • Elevated D-dimer and prolonged prothrombin time may not predict severe outcomes in this population.

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