Abstract Number: PB0183
Meeting: ISTH 2021 Congress
Background: Hematologic complications, including thrombosis, are well described in adults with COVID-19. Information regarding pediatric hematologic complications is limited.
Aims: Describe the hematologic complications of pediatric inpatients with COVID-19
Methods: An international, multi-center retrospective registry was created in June 2020 describing the clinical spectrum of COVID-19 hospitalized children. Information collected included: demographics, comorbidities, presentation, multi-system inflammatory syndrome (MIS-C) diagnosis, investigations, management and outcomes. Hematologic variables: were bleeding, signs of disseminated intravascular coagulation (DIC) and thrombosis or bleeding. Bleeding and MIS-C were defined per WHO criteria. DIC diagnosis was based on clinical judgement. Information was collected in Redcap and data analyzed using SAS.
Categorical data was reported as frequencies and proportions, continuous variables as means with standard deviations, or medians with interquartile range (IQRs) if data were skewed.
Results: 295 children were included and 104/295 (35%) had MISC. 107 (36.3%) children were admitted for alternate diagnosis with associated COVID-19 infection. 2 children (0.6%) developed thrombosis. 1 had an internal jugular vein thrombus and the other had extensive thromboembolism including pulmonary embolus (PE). 1 patient developed both PE and gastrointestinal (GI) hemorrhage. 5 children (1.7%) experienced bleeding where 4 had epistaxis and/or GI hemorrhage and 1 had pulmonary hemorrhage. 2 patients had DIC with bleeding. 4 children required blood products for management of hemorrhage. Rates of thrombosis and bleeding were similar between MIS-C and other COVID-19 patients. 117 (40%) children received prophylactic anti-coagulation (22 [7.4%] MIS-C patients) based on hospital specific policies. 5 (1.7%) deaths occurred in the cohort; all unrelated to COVID-19 associated hematologic complications.
Table 1: Demographics, clinical and laboratory features of inpatient children with COVID-19 and MISC
Conclusions: This registry describes COVID-19 related hematologic complications in a large multi-center pediatric cohort. The frequency of these complications is low and related to underlying comorbidities in children. Ongoing research is crucial to understand covid-associated hematological challenges in children and to determine the indications of prophylactic anti-coagulation.
To cite this abstract in AMA style:Tehseen S, Robinson J, Williams S, Lieberman L, PICNIC Paediatric Investigator Collaborative Network on Infections in Canada . COVID-19 Related Abnormalities in the Hematologic Characteristics among Inpatient Children. Results of the PICNIC Registry [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/covid-19-related-abnormalities-in-the-hematologic-characteristics-among-inpatient-children-results-of-the-picnic-registry/. Accessed May 16, 2022.
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