患有COVID-19的儿科患者的血栓事件和预防性抗凝药:系统性审查和元分析
Di Xie1, Xiaoming Xue2, Wenxiao Qiao1
1Shanxi Academy of Traditional Chinese Medicine, Taiyuan, Shanxi Province, People's Republic of China.
Hematology (Amsterdam, Netherlands)
|November 14, 2023
概括
在COVID-19的儿童中,静脉血栓栓塞 (VTE) 的发生率很低. 虽然预防性抗凝剂治疗显示出高安全性,但它并没有显著降低儿科患者的静脉瘤风险.
科学领域:
- 儿科医学 儿科医学 儿科医学
- 传染病 传染病 传染病
- 血液学 血液学 血液学
背景情况:
- 儿童的COVID-19可能导致静脉血栓栓塞 (VTE).
- 用抗凝固药治疗预防小儿VTE的有效性和安全性仍然不确定.
- 这项研究解决了对VTE发病率,D-二次体关联和COVID-19儿童预防性治疗疗效的清晰度的需求.
研究的目的:
- 为了确定儿童COVID-19患者中VTE的发病率.
- 为了研究D-二次体水平与VTE发生之间的关联.
- 在这个人群中评估预防性抗凝剂治疗的疗效和安全性.
主要方法:
- 进行了系统性审查和元分析.
- 在数据库中搜索了2020年1月至2023年2月期间发表的研究.
- 包括13项队列研究和1项临床试验.
主要成果:
- 在儿童COVID-19患者中,VTE的综合发病率为1.5%.
- 升高的D-二次体水平 (正常水平的五倍) 显著增加了静脉瘤风险 (OR 4.92).
- 预防性抗凝药并没有显著降低静脉瘤风险 (OR 1.35),但与较低的严重出血和死亡率 (<0.1%) 有关.
结论:
- 患有COVID-19的儿童的VTE发病率很低,这表明标准预防可能是合理的.
- 低分子量肝素 (LMWH) 证明了在VTE预防方面具有很高的安全性.
- 需要进一步进行高质量的研究,以充分阐明抗凝剂治疗对儿科COVID-19病例中静脉动脉突发症发病率的影响.
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