COVID‐19 anticoagulation recommendations in children

Loi, Michele; Branchford, Brian R.; Kim, John S.; Self, Chelsea; Nuss, Rachelle

doi:10.1002/pbc.28485

Cited by 60 publications

(73 citation statements)

References 16 publications

(18 reference statements)

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“…Recently published anticoagulation recommendations for children support the evaluation of children with SARS-CoV-2 infection for thrombosis, not only at admission but daily during hospitalization. 55 Because of the multiple risk factors, administration of prophylactic anticoagulant therapy for children is recommended only after careful consideration of each child's bleeding risk. 55 COVID-19 may cause disseminated intravascular coagulation in adult patients, with a mild decrease in platelet count and mild prolongation of partial thromboplastin time, but no signs of microangiopathy.…”

Section: The Risk Of Thrombotic Complications In Children With Covid-19mentioning

confidence: 99%

“…55 Because of the multiple risk factors, administration of prophylactic anticoagulant therapy for children is recommended only after careful consideration of each child's bleeding risk. 55 COVID-19 may cause disseminated intravascular coagulation in adult patients, with a mild decrease in platelet count and mild prolongation of partial thromboplastin time, but no signs of microangiopathy. 55 Meta-analysis of 551 pediatric cases showed that the prevalence of raised D-dimers was 12%, but there was no mention of thrombotic adverse events in the children.…”

Section: The Risk Of Thrombotic Complications In Children With Covid-19mentioning

confidence: 99%

“…55 COVID-19 may cause disseminated intravascular coagulation in adult patients, with a mild decrease in platelet count and mild prolongation of partial thromboplastin time, but no signs of microangiopathy. 55 Meta-analysis of 551 pediatric cases showed that the prevalence of raised D-dimers was 12%, but there was no mention of thrombotic adverse events in the children. 24 In the study of Lu and colleagues, the children had normal thrombin and prothrombin time and normal fibrinogen levels.…”

Section: The Risk Of Thrombotic Complications In Children With Covid-19mentioning

confidence: 99%

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Hematological manifestations of SARS‐CoV‐2 in children

Kosmeri

Koumpis

Tsabouri

et al. 2020

Pediatric Blood & Cancer

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Infection from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), though mainly a respiratory disease, can impair many systems, including causing hematological complications. Lymphopenia and hypercoagulability have been reported in adults with coronavirus disease 2019 (COVID-19) and are considered markers of poor prognosis. This review summarizes the hematological findings in children with SARS-CoV-2 infection. The majority of infected children had a normal leukocyte count, while the most common white blood cell abnormality was leukopenia. Lymphopenia, which may be a marker of severe disease, was rarer in children than in adults, possibly due to their immature immune system or due to the less severe manifestation of COVID-19 in this age group. Age may have an impact, and in neonates and infants the most common abnormality was lymphocytosis. Abnormalities of red blood cells and platelets were uncommon. Anemia and hypercoagulability were reported mainly in children presenting the novel multisystem inflammatory syndrome (MIS) associated with SARS-CoV-2.

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Section: The Risk Of Thrombotic Complications In Children With Covid-19mentioning

confidence: 99%

Section: The Risk Of Thrombotic Complications In Children With Covid-19mentioning

confidence: 99%

Section: The Risk Of Thrombotic Complications In Children With Covid-19mentioning

confidence: 99%

See 1 more Smart Citation

Hematological manifestations of SARS‐CoV‐2 in children

Kosmeri

Koumpis

Tsabouri

et al. 2020

Pediatric Blood & Cancer

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“…Major hematology organizations, including the American Society of Hematology (ASH) 8 and the International Society of Thrombosis Haemostasis (ISTH) 9 have published recommendations for anticoagulation of hospitalized symptomatic adults with SARS-CoV-2, which have been largely extrapolated to the pediatric population. A recent report by Loi et al 10 has made some diagnostic and therapeutic anticoagulation recommendations based on risk stratification of a single institutional experience. However, there remains a need in this population for laboratory-based risk-assessment tools to guide clinical decision making on the use of anticoagulant prophylaxis.…”

Section: Introductionmentioning

confidence: 99%

Are Children with SARS-CoV-2 Infection at High Risk for Thrombosis? Viscoelastic Testing and Coagulation Profiles in a Case Series of Pediatric Patients

Al-Ghafry

Aygün

Appiah‐Kubi

et al. 2020

Preprint

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The coagulopathy of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is well documented in adults, with increases in D-dimer and prothrombin time strong predictors of mortality and anticoagulation shown to decrease this mortality. Viscoelastic parameters such as elevations in maximum clot firmness (MCF) on rotational thromboelastometry (ROTEM) have correlated with a hypercoagulable state in adults with SARS-CoV-2. We report our experience in children infected with SARS-CoV-2, with noted elevations in D-dimer and MCF on ROTEM (indicating hypercoagulability). Exploration of viscoelastic testing to provide additional laboratory-based evidence for pediatric-specific risk-assessment for thromboprophylaxis in SARS-CoV-2 is warranted.

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“…The awareness of VTE association with COVID-19 has led to recommendations by the International Society of Thrombosis Hemostasis and others to consider prophylactic anticoagulation for hospitalized adults with COVID-19 (Spyropoulos et al, 2020). Similar recommendations for pediatric populations are being developed (Loi et al, 2020). These include labo- Prophylactic anticoagulation with LMWH has previously been shown to prevent thrombosis in at risk hospitalized adults (Dentali et al, 2007).…”

Section: To the Editormentioning

confidence: 99%