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Case Reports
. 2021 Jul;68(7):e29049.
doi: 10.1002/pbc.29049. Epub 2021 May 6.

How we approach thrombosis risk in children with COVID-19 infection and MIS-C

Affiliations
Case Reports

How we approach thrombosis risk in children with COVID-19 infection and MIS-C

Anjali A Sharathkumar et al. Pediatr Blood Cancer. 2021 Jul.

Abstract

Thrombosis within the microvasculature and medium to large vessels is a serious and common complication among critically ill individuals with coronavirus disease 2019 (COVID-19). While children are markedly less likely to develop severe disease than adults, they remain at risk for thrombosis during acute infection and with the post-acute inflammatory illness termed multisystem inflammatory syndrome in children. Significant knowledge deficits in understanding COVID-19-associated coagulopathy and thrombotic risk pose clinical challenges for pediatric providers who must incorporate expert opinion and personal experience to manage individual patients. We discuss clinical scenarios to provide framework for characterizing thrombosis risk and thromboprophylaxis in children with COVID-19.

Keywords: COVID-19; MIS-C; anticoagulation; thrombosis.

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Conflict of interest statement

The authors declare that there is no conflict of interest relevant to this publication.

Figures

FIGURE 1
FIGURE 1
Suggested algorithm for risk stratification and considering thromboprophylaxis for children with COVID‐19 infection. Note that location of patient and oxygen requirement was used for assessment of severity of acute infection. 4 Definitions: *VTE risk examples: MIS‐C, age ≥12 years, obesity, immobilization, CVL, estrogen, asparaginase, malignancy, soft tissue infection, family history of thrombosis; **Bleeding contraindications: active bleeding, significant risk of bleeding, platelet count <20,000 mm 3 . Abbreviations: CVL, central venous catheter; ICU, intensive care unit; O2, oxygen; PE, pulmonary emboli; ULN, upper limit of normal

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Publication types

Supplementary concepts