Rate of thrombosis in children and adolescents hospitalized with COVID-19 or MIS-C
| Autor: | Ayesha Zia, Leslie Raffini, Marisol Betensky, Wendy Seto Leung, Rosa E. Diaz, Clay T. Cohen, Julie Jaffray, Jacquelyn Keegan, Lance Ballester, Neil A. Goldenberg, Sarah E. Sartain, Riten Kumar, Lakshmi Srivaths, Kendra Malone, Stacey Rifkin-Zenenberg, Hilary B. Whitworth, Katherine Armstrong, Caroline Diorio, Anthony A. Sochet, Adrienne G. Randolph |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
business.industry Incidence (epidemiology) medicine.medical_treatment Immunology Retrospective cohort study Cell Biology Hematology 030204 cardiovascular system & hematology medicine.disease Biochemistry Thrombosis Asymptomatic Systemic inflammatory response syndrome 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis Internal medicine medicine Coagulopathy medicine.symptom business Stroke Central venous catheter |
| Zdroj: | Blood. 138:190-198 |
| ISSN: | 1528-0020 0006-4971 |
| DOI: | 10.1182/blood.2020010218 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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