Saddle pulmonary embolism in a pediatric patient with nephrotic syndrome and recent COVID-19 pneumonia: A case report

Abstract

The pediatric population accounts for a small portion of those with severe disease related to COVID-19. There are few published reports of hypercoagulable states in children with COVID-19. We describe an 11-year-old male with nephrotic syndrome who required inpatient treatment for COVID-19 pneumonia eight weeks prior. He returned to the emergency department with vomiting, tachypnea and was found to have a pulmonary embolism. In this case report, we discuss the risk factors for, presentation and evaluation of hypercoagulable state and its relation to COVID-19 in a pediatric patient.

Child with new onset nephrotic syndrome as the sole manifestation of SARS‐CoV‐2 infection

“…Venous thromboembolism occurs in roughly 3% of children with nephrotic syndrome, though incidence approaches 25% in high‐risk groups 10 . A case of pulmonary embolism in a child with nephrotic syndrome diagnosed 2 months before COVID‐19 infection has also been reported 11 . Taking into account this risk, anticoagulation prophylaxis was started.…”

“…10 A case of pulmonary embolism in a child with nephrotic syndrome diagnosed 2 months before COVID-19 infection has also been reported. 11 Taking into account this risk, anticoagulation prophylaxis was started.…”

Incidence of thromboembolism in children with primary nephrotic syndrome: a systematic review and metaanalysis

“…Observational studies on this issue are rare worldwide, and even fewer systematic reviews have been carried out. Currently, there is only one report on TE in children with PNS infected with the severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2, the causative agent of COVID-19) [ 11 ], and TE in patients with PNS after COVID-19 vaccination has only been reported in adults [ 12 ]. However, as risk factors for TE, infection with SARS‑CoV‑2 or vaccination with a COVID-19 vaccine might increase the occurrence of TE in children with PNS.…”