Thrombosis and hemorrhage experienced by hospitalized children with SARS-CoV-2 infection or MIS-C: Results of the PICNIC registry.

Autor: Tehseen S; Department of Laboratory medicine and Pediatrics, University of Saskatchewan, SHA, Saskatoon, Saskatchewan, Canada., Williams S; Division of Hematology Oncology, Hospital for Sick Children, Toronto, Ontario, Canada., Robinson J; Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada., Morris SK; Department of Pediatrics, Division of Infectious Diseases, University of Toronto, Toronto, Ontario, Canada., Bitnun A; Department of Pediatrics, Division of Infectious Diseases, University of Toronto, Toronto, Ontario, Canada., Gill P; Department of Pediatrics, Division of Infectious Diseases, University of Toronto, Toronto, Ontario, Canada., Tal TE; Department of Pediatrics, Division of Infectious Diseases, University of Toronto, Toronto, Ontario, Canada., Yeh A; Department of Pediatrics, Division of Infectious Diseases, University of Toronto, Toronto, Ontario, Canada., Yea C; Department of Pediatrics, Division of Infectious Diseases, University of Toronto, Toronto, Ontario, Canada., Ulloa-Gutierrez R; Department of Pediatrics, Hospital Nacional de Niños 'Dr. Carlos Sáenz Herrera,' Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica., Brenes-Chacon H; Department of Pediatrics, Hospital Nacional de Niños 'Dr. Carlos Sáenz Herrera,' Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica., Yock-Corrales A; Department of Pediatrics, Hospital Nacional de Niños 'Dr. Carlos Sáenz Herrera,' Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica., Ivankovich-Escoto G; Department of Pediatrics, Hospital Nacional de Niños 'Dr. Carlos Sáenz Herrera,' Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica., Soriano-Fallas A; Department of Pediatrics, Hospital Nacional de Niños 'Dr. Carlos Sáenz Herrera,' Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica., Papenburg J; Department of Pediatrics, McGill University, Montreal, Quebec, Canada., Lefebvre MA; Department of Pediatrics, McGill University, Montreal, Quebec, Canada., Scuccimarri R; Department of Pediatrics, McGill University, Montreal, Quebec, Canada., Nateghian A; Department of Pediatrics, Iran University of Medical Sciences, Tehran, Iran., Aski BH; Department of Pediatrics, Iran University of Medical Sciences, Tehran, Iran., Dwilow R; Department of Pediatrics, University of Manitoba, Winnipeg, Manitoba, Canada., Bullard J; Department of Pediatrics, University of Manitoba, Winnipeg, Manitoba, Canada., Cooke S; Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada., Restivo L; Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada., Lopez A; Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada., Sadarangani M; Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.; Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada., Roberts A; Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada., Forbes M; Department of Pediatrics, Western University, London, Ontario, Canada., Saux NL; Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada., Bowes J; Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada., Purewal R; Department of Pediatrics, University of Saskatchewan, Saskatoon, Saskatchewan, Canada., Lautermilch J; Department of Pediatrics, University of Saskatchewan, Saskatoon, Saskatchewan, Canada., Bayliss A; Department of Pediatrics, Trillium Health Partners, Mississauga, Ontario, Canada., Wong JK; Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada., Leifso K; Department of Pediatrics, Queen's University, Kingston, Ontario, Canada., Foo C; Department of Pediatrics, Memorial University, St John's, Newfoundland and Labrador, Canada., Panetta L; Department of Pediatrics, Universitie du Montreal, Montreal, Quebec, Canada., Kakkar F; Department of Pediatrics, Universitie du Montreal, Montreal, Quebec, Canada., Piche D; Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada., Viel-Theriault I; Department of Pediatrics, Laval University, Quebec, Quebec, Canada., Merckx J; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada., Lieberman L; Department of Laboratory Medicine and Pathobiology, University Health Network, Toronto, Ontario, Canada.
Jazyk: angličtina
Zdroj: Pediatric blood & cancer [Pediatr Blood Cancer] 2022 Sep; Vol. 69 (9), pp. e29793. Date of Electronic Publication: 2022 Jun 11.
DOI: 10.1002/pbc.29793
Abstrakt: Introduction: Coagulopathy and thrombosis associated with SARS-CoV-2 infection are well defined in hospitalized adults and leads to adverse outcomes. Pediatric studies are limited.
Methods: An international multicentered (n = 15) retrospective registry collected information on the clinical manifestations of SARS-CoV-2 and multisystem inflammatory syndrome (MIS-C) in hospitalized children from February 1, 2020 through May 31, 2021. This sub-study focused on coagulopathy. Study variables included patient demographics, comorbidities, clinical presentation, hospital course, laboratory parameters, management, and outcomes.
Results: Nine hundred eighty-five children were enrolled, of which 915 (93%) had clinical information available; 385 (42%) had symptomatic SARS-CoV-2 infection, 288 had MIS-C (31.4%), and 242 (26.4%) had SARS-CoV-2 identified incidentally. Ten children (1%) experienced thrombosis, 16 (1.7%) experienced hemorrhage, and two (0.2%) experienced both thrombosis and hemorrhage. Significantly prevalent prothrombotic comorbidities included congenital heart disease (p-value .007), respiratory support (p-value .006), central venous catheter (CVC) (p = .04) in children with primary SARS-CoV-2 and in those with MIS-C included respiratory support (p-value .03), obesity (p-value .002), and cytokine storm (p = .012). Comorbidities prevalent in children with hemorrhage included age >10 years (p = .04), CVC (p = .03) in children with primary SARS-CoV-2 infection and in those with MIS-C encompassed thrombocytopenia (p = .001) and cytokine storm (p = .02). Eleven patients died (1.2%), with no deaths attributed to thrombosis or hemorrhage.
Conclusion: Thrombosis and hemorrhage are uncommon events in children with SARS-CoV-2; largely experienced by those with pre-existing comorbidities. Understanding the complete spectrum of coagulopathy in children with SARS-CoV-2 infection requires ongoing research.
(© 2022 Wiley Periodicals LLC.)
Databáze: MEDLINE
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