Are children with SARS-CoV-2 infection at high risk for thrombosis? Viscoelastic testing and coagulation profiles in a case series of pediatric patients

Maha Al-Ghafry; Banu Aygun; Abena Appiah-Kubi; Adrianna Vlachos; Gholamabbas Ostovar; Christine Capone; Tod Sweberg; Nancy Palumbo; Pratichi Goenka; Lawrence W. Wolfe; Jeffrey M. Lipton; Suchitra S. Acharya

doi:10.1002/pbc.28737

Are children with SARS-CoV-2 infection at high risk for thrombosis? Viscoelastic testing and coagulation profiles in a case series of pediatric patients

Maha Al-Ghafry, Banu Aygun, Abena Appiah-Kubi, Adrianna Vlachos, Gholamabbas Ostovar, Christine Capone, Tod Sweberg, Nancy Palumbo, Pratichi Goenka, Lawrence W. Wolfe, Jeffrey M. Lipton, Suchitra S. Acharya

Research output: Contribution to journal › Article › peer-review

Abstract

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 found to be 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.

Original language	English (US)
Article number	e28737
Journal	Pediatric Blood and Cancer
Volume	67
Issue number	12
DOIs	https://doi.org/10.1002/pbc.28737
State	Published - Dec 1 2020
Externally published	Yes

Keywords

coagulation
COVID-19
rotational thromboelastometry
ROTEM
SARS-CoV-2
thrombosis
viscoelastic testing

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Hematology
Oncology

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10.1002/pbc.28737

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Al-Ghafry, M., Aygun, B., Appiah-Kubi, A., Vlachos, A., Ostovar, G., Capone, C., Sweberg, T., Palumbo, N., Goenka, P., Wolfe, L. W., Lipton, J. M., & Acharya, S. S. (2020). Are children with SARS-CoV-2 infection at high risk for thrombosis? Viscoelastic testing and coagulation profiles in a case series of pediatric patients. Pediatric Blood and Cancer, 67(12), Article e28737. https://doi.org/10.1002/pbc.28737

Al-Ghafry, M, Aygun, B, Appiah-Kubi, A, Vlachos, A, Ostovar, G, Capone, C, Sweberg, T, Palumbo, N, Goenka, P, Wolfe, LW, Lipton, JM & Acharya, SS 2020, 'Are children with SARS-CoV-2 infection at high risk for thrombosis? Viscoelastic testing and coagulation profiles in a case series of pediatric patients', Pediatric Blood and Cancer, vol. 67, no. 12, e28737. https://doi.org/10.1002/pbc.28737

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abstract = "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 found to be 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.",

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AU - Sweberg, Tod

AU - Palumbo, Nancy

AU - Goenka, Pratichi

AU - Wolfe, Lawrence W.

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AB - 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 found to be 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.

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Are children with SARS-CoV-2 infection at high risk for thrombosis? Viscoelastic testing and coagulation profiles in a case series of pediatric patients

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Keywords

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