loading page

Children and young adults hospitalized for  severe COVID-19 exhibit thrombotic coagulopathy        
  • +6
  • William Mitchell,
  • Jennifer Davila,
  • Janine Keenan,
  • Jenai Jackson,
  • Adit Tal,
  • Kerry Morrone,
  • Ellen Silver,
  • Sarah O'Brien,
  • Deepa Manwani
William Mitchell
Children's Hospital at Montefiore
Author Profile
Jennifer Davila
Children's Hospital at Montefiore
Author Profile
Janine Keenan
Children's Hospital at Montefiore
Author Profile
Jenai Jackson
Yeshiva University Albert Einstein College of Medicine
Author Profile
Adit Tal
Children's Hospital at Montefiore
Author Profile
Kerry Morrone
Children's Hospital at Montefiore
Author Profile
Ellen Silver
Yeshiva University Albert Einstein College of Medicine
Author Profile
Sarah O'Brien
Research Institute at Nationwide Children's Hospital
Author Profile
Deepa Manwani
Children's Hospital at Montefiore
Author Profile

Abstract

We report the clinical and laboratory coagulation characteristics of 27 pediatric and young adult patients (2 months to 21 years) treated for symptomatic COVID-19 at a children’s hospital in the Bronx, New York between March 1 and May 31, 2020. D-Dimer was > 0.5 ug/mL (upper limit of normal) in 25 (93%) patients at admission; 11 (41%) developed peak D-Dimer > 5 ug/mL during admission. Seven (26%) patients developed venous thromboembolism: three with deep vein thrombosis and four with pulmonary embolism. Requirement of increased ventilatory support was a risk factor for thrombosis (p=0.006). Three of eight (38%) patients on prophylactic anticoagulation developed thrombosis, however no patients developed VTE on low molecular weight heparin prophylaxis titrated to anti-Xa level. Manifestation of COVID-19 disease was severe or critical in 16 (59%) patients. Four (15%) patients died of COVID-19 complications: all had comorbidities. Elevated D-dimer and increased VTE rate were observed in this young cohort, particularly in those with severe respiratory complications suggesting thrombotic coagulopathy. More data is needed to guide thromboprophylaxis in this age group.

Peer review status:ACCEPTED

29 Sep 2020Submitted to Pediatric Blood & Cancer
29 Sep 2020Submission Checks Completed
29 Sep 2020Assigned to Editor
05 Oct 2020Reviewer(s) Assigned
15 Oct 2020Review(s) Completed, Editorial Evaluation Pending
22 Oct 2020Editorial Decision: Revise Major
21 Dec 2020Submission Checks Completed
21 Dec 20201st Revision Received
21 Dec 2020Assigned to Editor
24 Dec 2020Reviewer(s) Assigned
29 Dec 2020Review(s) Completed, Editorial Evaluation Pending
31 Dec 2020Editorial Decision: Revise Minor
19 Jan 20212nd Revision Received
19 Jan 2021Submission Checks Completed
19 Jan 2021Assigned to Editor
23 Jan 2021Reviewer(s) Assigned
26 Jan 2021Review(s) Completed, Editorial Evaluation Pending
28 Jan 2021Editorial Decision: Revise Minor
01 Feb 20213rd Revision Received
01 Feb 2021Submission Checks Completed
01 Feb 2021Assigned to Editor
02 Feb 2021Reviewer(s) Assigned
08 Feb 2021Review(s) Completed, Editorial Evaluation Pending
08 Feb 2021Editorial Decision: Accept