Abstract Number: PB0250
Meeting: ISTH 2021 Congress
Background: Thromboelastography (TEG) may estimate the dynamics of blood coagulation from the activation of clotting factors to fibrin formation, clot stabilization, and clot lysis. Therefore, TEG may be helpful to predict thromboembolic events and estimate clinical outcome in patients with COVID-19.
Aims: In this study, we wanted to evaluate the coagulation abnormalities including TEG analyses in children that are hospitalized for COVID-19 and aimed to assess the utility of TEG in clinical practice in terms of course of the disease, treatment response, and outcome.
Methods: A total of 66 patients who were ≤18 years old and hospitalized in infection ward for COVID-19 were evaluated prospectively. Clinical and laboratory findings at admission, course of the disease, treatment modalities, development of MIS-C, and outcome of patients were noted. Haemoscope TEG analyzer (Haemoscope, USA) was used.
Results: Five patients (7.6%) had thrombocytopenia. PT was prolonged in 5 patients (7.6%) and APTT in 3 patients (4.5%). Eight patients (12.1%) had elevated levels of D-dimer. A total of 16 patients (24.2%) had at least one abnormality at in TEG analysis. Eleven patients (16.6%) had an abnormality related to hypercoagulation such as decreased R/K, increased MA/Angle or increased CI. MIS-C developed in 3 patients (4.5%) during clinical follow-up; all of them had a normal graphic for TEG, even though they had increased D-dimer levels (>3000 ng/mL) at admission. There was no difference in TEG abnormalities between treated and untreated patients (p=0.76). Thromboembolic complications or bleeding events were not observed. None of the patients needed mechanical ventilation. None of them died.
Conclusions: Abnormal TEG features may be the most common finding regarding coagulopathy at admission in these patients, followed by elevated D-dimer levels. Abnormal TEG results at admission is not able to predict the course of the disease, treatment results, and outcome in pediatric patients who did not need mechanical ventilation.
To cite this abstract in AMA style:Hilkay Karapınar T, Böncüoğlu E, Oymak Y, Kıymet E, Tüfekçi Ö, Akaslan Kara A, Ötiken Arıkan K, Şahinkaya Ş, Çelik T, Bayram SN, Devrim İ, Ören H. The Role of Thromboelastography and Follow-up of Fibrinolysis in Evaluating the Course of the Disease, Treatment Response, and Outcome of Pediatric Patients with COVID-19 [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/the-role-of-thromboelastography-and-follow-up-of-fibrinolysis-in-evaluating-the-course-of-the-disease-treatment-response-and-outcome-of-pediatric-patients-with-covid-19/. Accessed December 6, 2023.
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