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Thromboprophylaxis Outcome in Childhood SARS-CoV-2 Infection: A Single-Center Experience
Mehran Karimi1, Anahita Sanaei Dashti2, Sezaneh Haghpanah1
1Hematology Research Center.
Insights
This study investigated thromboprophylaxis in pediatric COVID-19 patients, finding a low thrombosis rate (1.4%). Anticoagulant therapy may benefit severe pediatric coronavirus disease 2019 cases.
Area of Science:
- Pediatric Hematology
- Infectious Diseases
- Critical Care Medicine
Background:
- SARS-CoV-2 infection is linked to endothelial damage and thrombosis.
- Limited data exists on thrombosis and anticoagulant use in pediatric COVID-19 patients.
- Understanding COVID-19-associated coagulopathy in children is crucial.
Purpose of the Study:
- To evaluate the outcomes of thromboprophylaxis in hospitalized children with COVID-19.
- To assess the incidence of thrombosis in pediatric patients receiving anticoagulant therapy.
Main Methods:
- Retrospective study of 184 hospitalized pediatric patients with confirmed COVID-19.
- Data collected via questionnaire including demographics, clinical, and laboratory findings.
- Patients classified by disease severity (asymptomatic/mild to critically ill) per WHO criteria.
Main Results:
- Mean patient age was 7.04±5.9 years.
- 19 patients (all critically ill) died.
- Overall thrombosis rate was 1.4% (1 deep vein thrombosis with thromboprophylaxis, 1 pulmonary embolism without anticoagulation).
Conclusions:
- Pediatric COVID-19 patients exhibited a lower thrombosis rate (1.4%) compared to adults.
- Anticoagulant therapy might be beneficial for moderate to critically ill children with COVID-19.
- Significant knowledge gaps remain regarding pediatric COVID-19 coagulopathy and thrombotic risk.
Background:
The SARS-CoV-2 infection has been associated with potentially endothelial damage and coagulation cascade activation that cause thrombosis. There is limited information on thrombosis and anticoagulant therapy in children with coronavirus disease 2019 (COVID-19).
Aims:
This study evaluates the outcome of thromboprophylaxis in children younger than 18-year old with COVID-19 infection.
Methods:
A retrospective study was conducted on 184 hospitalized pediatric patients with confirmed COVID-19 infection. A designed questionnaire was made to collect all demographic, clinical, and laboratory data. According to World Health Organization, the patients were classified as asymptomatic/mild, moderate, severe, and critically ill.
Results:
The mean age of the patients was 7.04±5.9 (1 wk to younger than 18 y). Overall, 33 patients received anticoagulant therapy. All patients who passed away (n=19) belonged to the critical group. One patient (1.28%) was complicated with deep vein thrombosis despite taking thromboprophylaxis, and 1 (1.28%) with pulmonary thromboembolism while the patient did not take an anticoagulant.
Conclusions:
Our data showed a lower rate of thrombosis (1.4%) than adult patients with COVID-19. It may underline the role of anticoagulants in moderate to severe/critically ill children with COVID-19 infection. Expert opinion and personal experience are necessary, while we have a significant knowledge gap in understanding COVID-19-associated coagulopathy and thrombotic risk in children.
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