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- Hilary Whitworth
- Department of Pediatrics, Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA;
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- Sarah E. Sartain
- Department of Pediatrics, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX;
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- Riten Kumar
- Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, MA;
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- Katherine Armstrong
- Department of Pediatrics, Joseph M. Sanzari Children’s Hospital, Hackensack University Medical Center, Hackensack, NJ;
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- Lance Ballester
- Department of Pediatrics, Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA;
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- Marisol Betensky
- Division of Hematology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD;
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- Clay T. Cohen
- Department of Pediatrics, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX;
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- Rosa Diaz
- Department of Pediatrics, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX;
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- Caroline Diorio
- Department of Pediatrics, Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA;
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- Neil A. Goldenberg
- Division of Hematology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD;
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- Julie Jaffray
- Department of Pediatrics, Children’s Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA;
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- Jacquelyn Keegan
- Department of Pediatrics, Children’s Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA;
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- Kendra Malone
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX;
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- Adrienne G. Randolph
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, MA;
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- Stacey Rifkin-Zenenberg
- Department of Pediatrics, Joseph M. Sanzari Children’s Hospital, Hackensack University Medical Center, Hackensack, NJ;
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- Wendy Seto Leung
- Department of Pediatrics, Children’s Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA;
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- Anthony Sochet
- Division of Pediatric Critical Care Medicine, Department of Anesthesia and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; and
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- Lakshmi Srivaths
- Department of Pediatrics, University of Texas Houston, Houston, TX
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- Ayesha Zia
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX;
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- Leslie Raffini
- Department of Pediatrics, Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA;
抄録
<jats:title>Abstract</jats:title> <jats:p>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.</jats:p>
収録刊行物
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- Blood
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Blood 138 (2), 190-198, 2021-04-25
American Society of Hematology