Thrombophilia in Pediatric Patients with Multisystem Inflammatory Syndrome in Children Secondary to Coronavirus Disease 2019 Supported on Extracorporeal Membrane Oxygenation

Minen, Federico; Hands, Christopher; Mustafa, Muhammad; Pienaar, Alison; Lillie, Jon

doi:10.1097/mat.0000000000001270

Cited by 18 publications

(40 citation statements)

References 13 publications

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“…After reading the full texts, 7 were excluded (summarized in the Supplementary Table ) [13] , [14] , [15] , [16] , [11] , [17] , [18] . Twelve articles were case reports ( Table 1 ) [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] . In addition, an international survey [31] and a prospective multicenter study were included [32] ( Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“… [30] . In total, 3 studies were conducted in the united States [24] , [25] , [27] , 4 in Europe [23] , [26] , [29] , [30] , 3 in Asia [19] , [20] , [22] , 1 in South America [28] , and 1 in South Africa [21] . Nine studies were published in 2020 [19] , [21] , [22] , [23] , [24] , [25] , [28] , [29] , [30] .…”

Section: Resultsmentioning

confidence: 99%

“…Nine studies were published in 2020 [19] , [21] , [22] , [23] , [24] , [25] , [28] , [29] , [30] . The total number of patients was 10 females [19] , [21] , [23] , [25] , [26] , [27] , [29] , [30] and 9 males [20] , [22] , [24] , [26] , [28] , [30] . Eight case reports included patients without comorbidity ( n = 14 children) [19] , [20] , [22] , [23] , [25] , [26] , [28] , [30] ; comorbidities ( n = 5) included: tubercolus meningitis (n = 1) [21] , sickle cell disease (n = 1) [29] , asthma (n = 1) [24] , and obesity ( n = 2) [26] , [27] .…”

Section: Resultsmentioning

confidence: 99%

“…Diagnosis of COVID-19 infection was based on RT-PCR assay results of nasopharyngeal swab in 10 studies [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [29] , [30] , SAR-CoV-2-IgM antibody in 1 study [27] and post mortem histopathological examination of the heart showing spherical viral particles consistent with the Coronaviridae family in 1 study [28] .…”

Section: Resultsmentioning

confidence: 99%

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Thrombotic risk in children with COVID-19 infection: A systematic review of the literature

Zaffanello

Piacentini

Nosetti

et al. 2021

Thrombosis Research

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Coagulation and inflammatory parameters are mildly altered in children with SARS-CoV-2 (COVID-19) infection, and laboratory evidence of a proinflammatory and procoagulant state has been noted in multisystem inflammatory syndrome in children (MIS-C). It is not clear whether this pediatric condition is related to thrombotic events. With this study we reviewed the literature for thrombotic complications in children with COVID-19 infection and MIS-C. Data sources: We searched the Medline PubMed Advanced Search Builder, Scopus, Web Of Science, and Google Scholar electronic databases (until 1 January 2021) using the medical subject headings (MeSH) terms and text words (their combinations and truncated synonyms): (THROMBOSIS OR THROMBOPHILIA) AND (CHILD OR CHILDREN OR INFANT) AND (COVID-19 OR SARS-CoV-2). Study eligibility criteria: Inclusion criteria were children with COVID-19 or SARS-COV-2 infection. The search was limited to articles published in English. Exclusion criteria were: reviews of published studies, studies published only as abstracts, letters or conference proceedings, discussion papers, animal studies, or editorials. Results: After screening for duplicates, the initial search yielded 86 records: 12 were case reports involving 19 children; comorbidities were absent or mild in 73.7%. The most common site of thrombosis the lung (21%); the most often used drug was heparin (42%). Two studies were an international survey (n = 337 patients) and a large multicenter study (n = 186 patients with MIS-C). The risk of ischemic stroke in SARS-CoV-2 infection (0.82%) and deep venous thrombosis in MIS-C (4.3%) was lower in children than in adults. Conclusions: Thrombodic or thromboembolic events are rare in pediatric patients with COVID-19 infection and MIS-C. Nonetheless, as in adults, a high index of suspicion should be maintained in children with COVID-19 infection or MIS-C, particularly in those with comorbidities predisposing to thrombotic events.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Thrombotic risk in children with COVID-19 infection: A systematic review of the literature

Zaffanello

Piacentini

Nosetti

et al. 2021

Thrombosis Research

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“…56 Consistently, as recently Although there is insufficient data regarding the safety and effectiveness of highly invasive procedures such as ECMO, they may be performed in medically intractable MIS-C patients. 58…”

Section: Treatmentmentioning

confidence: 99%

A Novel and Severe Clinical Picture Related to COVID-19: Multi-Inflammatory Syndrome in Children

Haşlak¹,

Yi̇ldi̇z²,

Şahin³

et al. 2021

Trends in Pediatrics

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Preliminary data have suggested that children have milder COVID-19 disease course compared to adults. However, pediatric cases with severe clinical findings caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) are being reported since April 2020. These children have been presented with significant hyperinflammatory states resembling Kawasaki disease, toxic shock syndrome, and macrophage activation syndrome. However, they had several distinct features, as well. Therefore, this novel condition was considered a unique disease and named Multi-inflammatory syndrome in children (MIS-C). Thus, new concerns have been raised regarding the vulnerability of the children. However, it has been realized that this condition is extremely rare. Nonetheless, considering that it is a life-threatening disease and may cause devastating consequences, clinicians should be aware of MIS-C while evaluating children with persistent fever and history of COVID-19 contact or active infection.

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Thromboelastography profiles in critically ill children with multisystem inflammatory syndrome

Morparia

Spinella

McQueen

et al. 2021

Pediatric Blood & Cancer

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Objectives: To describe critically ill children's coagulation profile with the multisystem inflammatory syndrome (MIS-C) related to coronavirus. Study design: Single-center, observational study at a tertiary, pediatric intensive care unit (PICU) in children aged 1 month to 18 years. Measurements and main results: Sixteen children, with a median age of 5.4 years (interquartile range [IQR] 2.1, 11.75), 56% female, admission Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score of 3.5 (IQR 2, 5), and median PICU length of stay 3 days (IQR 1.5, 4), met criteria of MIS-C. All patients received acetylsalicylic acid (80-100 mg/kg) and none received anticoagulation. Sixty-three percent (10/16) of children had out-of-normal range values on thromboelastography (TEG) (44% [7/16] with hypercoagulability and 19% [3/16] with hypocoagulability). Of those with hypercoagulability, 19% (3/16) had rapid clot formation, and 25% (4/16) had increased clot strength. In 69% (11/16) of children, there was impaired fibrinolysis (0% lysis at 30 minutes) on TEG. Seventy-five percent (12/16) of children had out-of-normal range value on standard coagulation assays (37.5% [6/16] with hypocoagulability and 37.5% [6/16] with hypercoagulability). TEG-G (clot strength as measured by TEG) value (ρ −.553, p = .033) and platelet count (ρ −.840, p < .0001) were correlated with admission PELOD-2 score. TEG-G value (ρ −.506, p = .04) and platelet count (ρ −.539, p = .03) were correlated with the duration of intensive care unit stay. Conclusions: Coagulation abnormalities are frequent in children with MIS-C. TEG parameter and platelet count are correlated with the severity of multiorgan dysfunction and the duration of intensive care stay. Multicenter studies are needed to confirm the clinical implications of these coagulation abnormalities.

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Thrombophilia in Pediatric Patients with Multisystem Inflammatory Syndrome in Children Secondary to Coronavirus Disease 2019 Supported on Extracorporeal Membrane Oxygenation

Cited by 18 publications

References 13 publications

Thrombotic risk in children with COVID-19 infection: A systematic review of the literature

Thrombotic risk in children with COVID-19 infection: A systematic review of the literature

A Novel and Severe Clinical Picture Related to COVID-19: Multi-Inflammatory Syndrome in Children

Thromboelastography profiles in critically ill children with multisystem inflammatory syndrome

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