Introduction
Adult patients with severe COVID-19 develop a thrombotic coagulopathy, and numerous series have reported high rates of venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE),1-4 however, these adult cohorts have median ages of 63-64 years. Data have been presented on pediatric cohorts with COVID-19, however, the associated coagulopathy has not been well described.5-10 In particular, whether an aggressive anticoagulation strategy, as has been implemented in some medical centers, is necessary, effective or safe for children and young adults is not clear. Defining the clinical characteristics and severity of the coagulopathy of COVID-19 in hospitalized pediatric patients is an urgent need. In this context, we performed a single-site retrospective review of 27 patients ages 2 months to 21 years, with confirmed, symptomatic COVID-19, admitted to a single Children’s Hospital in the Bronx, New York. We describe the coagulopathy associated with COVID-19 in these hospitalized patients and how these data informed the iterative process that led to the development of institutional anticoagulation guidelines.