Abstract
Background: The incidence and severity of coagulation abnormalities have not been extensively studied in pediatric populations with coronavirus disease 2019 (COVID-19). Moreover, their association with an increased risk for thromboembolic events remains unclear, and there is a lack of evidence for optimal prophylactic antithrombotic management. The aim of our study was to present our experience in evaluation, management, and long-term outcomes of coagulation abnormalities in pediatric hospitalized patients with COVID-19.
Methods: A prospective study was performed in all children hospitalized for COVID-19 during a 6-month period focusing on patients’ coagulation abnormalities, the normalization of the coagulation profile with or without anticoagulation prophylaxis and the clinical outcome of the disease.
Results: Two hundred twenty-three patients (median age: 11.4 months) were enrolled in the study. Coagulation abnormalities were detected in 92.4% of patients with increased D-dimer levels to be the most common abnormality detected in 84.3% of patients. Prophylactic anticoagulation was initiated only in 7 (3.1%) selected patients with severe COVID-19 and at least 2 risk factors for venous thromboembolism (VTE) and in all patients with previous history of VTE. Follow-up coagulation profile in 85 patients showed that changes over time had a tendency towards normalization irrespectively of the initiation of anticoagulant thromboprophylaxis. No thrombotic complications were observed 3 months upon discharge.
Conclusions: Although abnormal findings in coagulation profile were very common, they were not associated with risk for VTE even in severe cases. A trend of normalization early in the course of the disease was observed regardless of the use of anticoagulant thromboprophylaxis.
【초록키워드】 COVID-19, coronavirus disease, Coronavirus disease 2019, Hospitalized, anticoagulation, severe COVID-19, Thrombotic complications, pediatric, children, severity, Prospective Study, risk, outcome, Prophylactic, risk factor, Venous Thromboembolism, discharge, Population, Coagulation, Clinical outcome, Prophylaxis, management, Patient, severe cases, incidence, change, patients, association, prophylactic anticoagulation, Thromboprophylaxis, Anticoagulant, Evidence, Antithrombotic, D-dimer level, VTE, thromboembolic, Thromboembolic events, increased risk, median age, thrombotic, Abnormalities, normalization, abnormality, tendency, Thromboembolic event, thrombotic complication, Course, enrolled, selected, lack, the disease, was performed, median, hospitalized patient, initiated, with COVID-19, 【제목키워드】 COVID-19,