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