Thrombosis and hemorrhage experienced by hospitalized children with SARS-CoV-2 infection or MIS-C: Results of the PICNIC registry.
COVID-19
MIS-C
SARS-CoV-2
c
hemorrhage
pediatric
thrombosis
Journal
Pediatric blood & cancer
ISSN: 1545-5017
Titre abrégé: Pediatr Blood Cancer
Pays: United States
ID NLM: 101186624
Informations de publication
Date de publication:
09 2022
09 2022
Historique:
revised:
06
04
2022
received:
07
01
2022
accepted:
26
04
2022
pubmed:
12
6
2022
medline:
27
7
2022
entrez:
11
6
2022
Statut:
ppublish
Résumé
Coagulopathy and thrombosis associated with SARS-CoV-2 infection are well defined in hospitalized adults and leads to adverse outcomes. Pediatric studies are limited. 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. 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. 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.
Identifiants
pubmed: 35689507
doi: 10.1002/pbc.29793
pmc: PMC9350140
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e29793Informations de copyright
© 2022 Wiley Periodicals LLC.
Références
Acta Paediatr. 2020 Jun;109(6):1088-1095
pubmed: 32202343
J Pediatr Surg. 2021 Feb;56(2):302-308
pubmed: 32713711
J Thromb Haemost. 2020 Jun;18(6):1421-1424
pubmed: 32271988
Pediatrics. 2009 Oct;124(4):1001-8
pubmed: 19736261
Curr Med Res Opin. 2014 Jun;30(6):1065-9
pubmed: 24450577
Ann Rheum Dis. 2016 Mar;75(3):481-9
pubmed: 26865703
Thromb Res. 2020 Jul;191:145-147
pubmed: 32291094
Arch Pediatr. 2020 Jul;27(5):235-238
pubmed: 32518045
Semin Thromb Hemost. 2018 Feb;44(1):52-56
pubmed: 28778103
N Engl J Med. 2020 Jul 23;383(4):334-346
pubmed: 32598831
Front Immunol. 2021 Jun 11;12:646894
pubmed: 34177895
CMAJ. 2020 May 25;192(21):E583
pubmed: 32357997
J Thromb Haemost. 2021 Feb;19(2):522-530
pubmed: 33305475
Arthritis Rheumatol. 2020 Jul;72(7):1059-1063
pubmed: 32293098
J Intern Med. 2020 Dec;288(6):737-739
pubmed: 32506640
Paediatr Int Child Health. 2021 Feb;41(1):56-64
pubmed: 33616026
Pediatr Blood Cancer. 2021 Jul;68(7):e28975
pubmed: 33661561
Blood. 2021 Jul 15;138(2):190-198
pubmed: 33895804
J Thromb Haemost. 2017 Nov;15(11):2274-2278
pubmed: 29027741
Ann Intern Med. 2021 May;174(5):622-632
pubmed: 33493012
World J Pediatr. 2021 Feb;17(1):71-78
pubmed: 33387256
Pediatr Blood Cancer. 2021 Dec;68(12):e29355
pubmed: 34532964
J Thromb Haemost. 2021 Jul;19(7):1764-1770
pubmed: 33872443
Curr Med Res Opin. 2012 Jan;28(1):79-87
pubmed: 22117897
J Thromb Haemost. 2020 Sep;18(9):2103-2109
pubmed: 32558075
Indian J Pediatr. 2020 Jul;87(7):537-546
pubmed: 32410003
Chest. 2011 Jan;139(1):69-79
pubmed: 20453069
Ann Thorac Surg. 2007 May;83(5):1797-803
pubmed: 17462402
J Thromb Haemost. 2020 Aug;18(8):1995-2002
pubmed: 32369666
Pediatr Blood Cancer. 2020 Dec;67(12):e28737
pubmed: 33098753
Eur J Pediatr. 2021 Mar;180(3):689-697
pubmed: 32914200
J Thromb Haemost. 2020 Apr;18(4):786-787
pubmed: 32212240
Lancet. 2020 Feb 15;395(10223):497-506
pubmed: 31986264
Ann Neurol. 2021 Apr;89(4):657-665
pubmed: 33332607
J Pediatr Surg. 2008 Jun;43(6):1095-9
pubmed: 18558189
Lancet Haematol. 2020 Jun;7(6):e438-e440
pubmed: 32407672
Haematologica. 2015 Aug;100(8):1045-50
pubmed: 26001789
J Vasc Surg. 2012 Jun;55(6):1785-93
pubmed: 21944920
CMAJ. 2021 Sep 27;193(38):E1483-E1493
pubmed: 34580141
Circulation. 2020 Jul 14;142(2):184-186
pubmed: 32330083
Pediatr Blood Cancer. 2022 Sep;69(9):e29793
pubmed: 35689507
Thromb Res. 2021 Sep;205:92-98
pubmed: 34293539
J Pediatr. 2017 May;184:114-119.e6
pubmed: 28185627
Circulation. 2021 Jan 12;143(2):135-144
pubmed: 33200947
PLoS Med. 2007 Oct 16;4(10):e297
pubmed: 17941715