Limited data on the coagulation profile in children affected by the SARS-CoV-2 infection are available. We aimed to evaluate the role of d-dimers as predictors of poor outcomes in a pediatric population affected by the SARS-CoV-2 infection or multisystem inflammatory syndrome (MIS-C). We performed a retrospective cross-sectional multicenter study. Data from four different centers were collected. Laboratory tests, when performed, were collected at the time of diagnosis, and 24, 48, 72, 96, 120 and beyond 120 h from diagnosis; blood counts with formula, an international normalized ratio (INR), activated partial thromboplastin time (aPTT), D-dimers and fibrinogen values were collected. Data regarding clinical history, management and outcome of the patients were also collected. Three hundred sixteen patients with a median age of 3.93 years (IQR 0.62–10.7) diagnosed with COVID-19 or MIS-C were enrolled. Fifty-eight patients (18.3%) showed a severe clinical outcome, 13 (4.1%) developed sequelae and 3 (0.9%) died. The univariate analysis showed that age, high D-dimer values, hyperfibrinogenemia, INR and aPTT elongation, and low platelet count were associated with an increased risk of pediatric intensive care unit (PICU) admission ( p < 0.01). Three multivariate logistic regressions showed that a d-dimer level increase was associated with a higher risk of PICU admission. This study shows that D-dimer values play an important role in predicting the more severe spectrum of the SARS-CoV-2 infection, and was higher also in those that developed sequelae, including long COVID-19.
【저자키워드】 COVID-19, SARS-CoV-2, children, Coagulation, D-dimers, 【초록키워드】 intensive care, cross-sectional, pediatric, Infection, Diagnosis, D-dimer, outcome, MIS-C, Clinical outcome, management, International, Patient, Platelet, age, predictor, multicenter, Admission, Blood, retrospective, Inflammatory, higher risk, increased risk, median age, D-dimer values, multivariate logistic regression, syndrome, Univariate analysis, D-dimer value, clinical history, enrolled, performed, affected, collected, evaluate, died, the patient, activated, diagnosed with COVID-19, fibrinogen value, INR, IQR, Limited, normalized, the SARS-CoV-2, 【제목키워드】 clinical, profile,