COVID-19-Associated Pulmonary Embolism in Pediatric Patients.

Autor:	Chima M; College of Medicine and., Williams D; Pediatric Critical Care, Department of Pediatrics, College of Medicine, Penn State Health Children's Hospital, Hershey, Pennsylvania., Thomas NJ; Pediatric Critical Care, Department of Pediatrics, College of Medicine, Penn State Health Children's Hospital, Hershey, Pennsylvania.; Department of Public Health Sciences Pennsylvania State University, Hershey, Pennsylvania; and., Krawiec C; Pediatric Critical Care, Department of Pediatrics, College of Medicine, Penn State Health Children's Hospital, Hershey, Pennsylvania ckrawiec@pennstatehealth.psu.edu.
Jazyk:	angličtina
Zdroj:	Hospital pediatrics [Hosp Pediatr] 2021 Jun; Vol. 11 (6), pp. e90-e94. Date of Electronic Publication: 2021 Mar 30.
DOI:	10.1542/hpeds.2021-005866
Abstrakt:	Background and Objectives: Coronavirus disease 2019 (COVID-19) is associated with pulmonary embolism in adults, but the clinical circumstances surrounding its presence are unknown in children. The objectives of this study are to determine the prevalence of pulmonary embolism in pediatric subjects with COVID-19, evaluate patient characteristics, and describe treatments applied. Methods: We performed a retrospective cohort study using TriNetX electronic health record data of subjects aged <18 years who were diagnosed with COVID-19 infection ( International Classification of Diseases, 10th Revision , code U07.1). Pulmonary embolism was identified by using International Classification of Diseases, 10th Revision , code I26. We additionally collected data on age, sex, race, ethnicity, all diagnostic codes, medications, procedures, laboratory results, comorbidities, and outcomes. Results: During the study period, 24 723 pediatric subjects were reported to have a COVID-19 infection diagnosis among 41 health care organizations, of which 693 (2.8%) were hospitalized. Eight subjects (0.03% overall and 1.2% of hospitalized patients) were diagnosed with pulmonary embolism. The median age (25th to 75th percentile) of patients diagnosed with pulmonary embolism was 16.5 years, and median (25th to 75th percentile) BMI was 22.1 (19.6-47.9). Three (37.5%) received critical care services, and 1 (12.5%) underwent mechanical ventilation. Five (62.5%) subjects had potentially significant risk factors (obesity, malignancy, recent surgery, and oral contraceptive use). All patients received anticoagulation, but none underwent thrombolysis. There were no reported deaths. Conclusions: Although pulmonary embolism is diagnosed less commonly in children than in adults, its occurrence appears to be more frequent in children hospitalized with COVID-19, as compared with previous reports in hospitalized children in general. All patients survived, with only 1 requiring mechanical ventilation. Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose. (Copyright © 2021 by the American Academy of Pediatrics.)
Databáze:	MEDLINE
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