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Rate of thrombosis in children and adolescents hospitalized with COVID-19 or MIS-C.
Whitworth, Hilary; Sartain, Sarah E; Kumar, Riten; Armstrong, Katherine; Ballester, Lance; Betensky, Marisol; Cohen, Clay T; Diaz, Rosa; Diorio, Caroline; Goldenberg, Neil A; Jaffray, Julie; Keegan, Jacquelyn; Malone, Kendra; Randolph, Adrienne G; Rifkin-Zenenberg, Stacey; Leung, Wendy Seto; Sochet, Anthony; Srivaths, Lakshmi; Zia, Ayesha; Raffini, Leslie.
Afiliação
  • Whitworth H; Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA.
  • Sartain SE; Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX.
  • Kumar R; Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA.
  • Armstrong K; Department of Pediatrics, Joseph M. Sanzari Children's Hospital, Hackensack University Medical Center, Hackensack, NJ.
  • Ballester L; Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA.
  • Betensky M; Division of Hematology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Cohen CT; Thrombosis Program and Institute for Clinical and Translational Research, Johns Hopkins All Children's Hospital, St Petersburg, FL.
  • Diaz R; Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX.
  • Diorio C; Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX.
  • Goldenberg NA; Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA.
  • Jaffray J; Division of Hematology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Keegan J; Thrombosis Program and Institute for Clinical and Translational Research, Johns Hopkins All Children's Hospital, St Petersburg, FL.
  • Malone K; Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Randolph AG; Department of Pediatrics, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA.
  • Rifkin-Zenenberg S; Department of Pediatrics, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA.
  • Leung WS; Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX.
  • Sochet A; Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA.
  • Srivaths L; Department of Pediatrics, Joseph M. Sanzari Children's Hospital, Hackensack University Medical Center, Hackensack, NJ.
  • Zia A; Department of Pediatrics, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA.
  • Raffini L; Division of Pediatric Critical Care Medicine, Department of Anesthesia and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; and.
Blood ; 138(2): 190-198, 2021 07 15.
Article em En | MEDLINE | ID: mdl-33895804
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with thrombotic complications in adults, but the incidence of COVID-19-related thrombosis in children and adolescents is unclear. Most children with acute COVID-19 have mild disease, but coagulopathy has been associated with multisystem inflammatory syndrome in children (MIS-C), a postinfectious complication. We conducted a multicenter retrospective cohort study to determine the incidence of thrombosis in children hospitalized with COVID-19 or MIS-C and evaluate associated risk factors. We classified patients into 1 of 3 groups for analysis: COVID-19, MIS-C, or asymptomatic SARS-CoV-2. Among a total of 853 admissions (COVID-19, n = 426; MIS-C, n = 138; and asymptomatic SARS-CoV-2, n = 289) in 814 patients, there were 20 patients with thrombotic events (TEs; including 1 stroke). Patients with MIS-C had the highest incidence (9 [6.5%] of 138) vs COVID-19 (9 [2.1%] of 426) or asymptomatic SARS-CoV-2 (2 [0.7%] of 289). In patients with COVID-19 or MIS-C, a majority of TEs (89%) occurred in patients age ≥12 years. Patients age ≥12 years with MIS-C had the highest rate of thrombosis at 19% (9 of 48). Notably, 71% of TEs that were not present on admission occurred despite thromboprophylaxis. Multivariable analysis identified the following as significantly associated with thrombosis: age ≥12 years, cancer, presence of a central venous catheter, and MIS-C. In patients with COVID-19 or MIS-C, hospital mortality was 2.3% (13 of 564), but it was 28% (5 of 18) in patients with TEs. Our findings may help inform pediatric thromboprophylaxis strategies.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Trombose / Síndrome de Resposta Inflamatória Sistêmica / COVID-19 Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: Blood Ano de publicação: 2021 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Trombose / Síndrome de Resposta Inflamatória Sistêmica / COVID-19 Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: Blood Ano de publicação: 2021 Tipo de documento: Article País de publicação: Estados Unidos