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Microvascular dysfunction in pediatric patients with SARS-COV-2 pneumonia: report of three severe cases

G Bottari1, E Damiani2, V Confalone1

  • 1Pediatric Emergency Department Pediatric Intensive Care Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Microvascular Research
|January 13, 2022
PubMed

Insights

Severe COVID-19 infection in children can cause microvascular dysfunction. Sublingual microcirculation analysis may help monitor this in pediatric patients, offering a valuable bedside technique for detecting thrombosis complications.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • The COVID-19 pandemic has impacted global health, with children often presenting mild symptoms.
  • Vulnerable pediatric populations, including newborns and those with comorbidities, face higher risks from COVID-19.
  • Microvascular dysfunction has been observed in adults with severe COVID-19.

Purpose of the Study:

  • To report the first known cases of microvascular dysfunction in children with severe COVID-19 requiring pediatric critical care.
  • To investigate alterations in sublingual microcirculation in pediatric COVID-19 patients.
  • To assess the utility of bedside microcirculation analysis in managing severe pediatric COVID-19.

Main Methods:

  • Case series of three pediatric patients with COVID-19 infection requiring critical care.
  • Sublingual microcirculation assessment using advanced imaging techniques.
  • Comparison of findings with adult COVID-19 microcirculation data and MIS-C cases.

Main Results:

  • Sublingual microcirculation was found to be altered in children with severe COVID-19.
  • Observed microcirculatory changes in pediatric COVID-19 differ from those seen in adult severe COVID-19 and MIS-C.
  • Direct correlation between microcirculation analysis and clinical/laboratory parameters was not established in this series.

Conclusions:

  • Sublingual microcirculation analysis provides direct insight into microcirculatory dysfunction in pediatric COVID-19 patients.
  • This bedside technique may serve as a valuable tool for monitoring potential thrombosis complications in critically ill children with COVID-19.
  • Further research is needed to fully elucidate the relationship between microcirculatory changes and clinical outcomes in pediatric COVID-19.

Keywords:
COVID-19ChildrenCoagulationNewbornsPediatric critical careSublingual microcirculation analysis

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