Thromboelastography profiles in critically ill children with multisystem inflammatory syndrome

Area of Science:

• Pediatric critical care medicine
• Hematology
• Infectious diseases

Background:

• Multisystem inflammatory syndrome in children (MIS-C) is a serious condition linked to coronavirus infections.
• Coagulation disturbances are increasingly recognized in MIS-C patients, but their specific characteristics require further elucidation.

Purpose of the Study:

• To characterize the coagulation profile of critically ill children diagnosed with MIS-C.
• To investigate the relationship between coagulation parameters, disease severity, and intensive care unit (ICU) stay.

Main Methods:

• A single-center, observational study was conducted in a pediatric intensive care unit (PICU).
• Sixteen children meeting MIS-C criteria (aged 1 month to 18 years) were analyzed.
• Thromboelastography (TEG) and standard coagulation assays were performed; Pediatric Logistic Organ Dysfunction-2 (PELOD-2) scores were used to assess severity.

Main Results:

• Coagulation abnormalities were frequent, with 63% of children showing abnormal TEG values (hypercoagulability in 44%, hypocoagulability in 19%) and 69% exhibiting impaired fibrinolysis.
• Standard coagulation assays also revealed abnormalities in 75% of patients (hypocoagulability in 37.5%, hypercoagulability in 37.5%).
• TEG-G (clot strength) and platelet count significantly correlated with admission PELOD-2 scores and ICU length of stay.

Conclusions:

• Coagulopathy is a common finding in children with MIS-C.
• TEG parameters and platelet count serve as potential indicators of disease severity and prognosis in these patients.
• Further multicenter research is warranted to confirm the clinical significance of these coagulation abnormalities.