Thrombosis and hemorrhage experienced by hospitalized children with SARS-CoV-2 infection or MIS-C: Results of the PICNIC registry.

Content Provider	Europe PMC
Author	Tehseen, Sarah Williams, Suzan Robinson, Joan Morris, Shaun K. Bitnun, Ari Gill, Peter Tal, Tala El Yeh, Ann Yea, Carmen Ulloa‐Gutierrez, Rolando Brenes‐Chacon, Helena Yock‐Corrales, Adriana Ivankovich‐Escoto, Gabriela Soriano‐Fallas, Alejandra Papenburg, Jesse Lefebvre, Marie‐Astrid Scuccimarri, Rosie Nateghian, Alireza Aski, Behzad Haghighi Dwilow, Rachel Bullard, Jared Cooke, Suzette Restivo, Lea Lopez, Alison Sadarangani, Manish Roberts, Ashley Forbes, Michelle Saux, Nicole Le Bowes, Jennifer Purewal, Rupeena Lautermilch, Janell Bayliss, Ann Wong, Jacqueline K. Leifso, Kirk Foo, Cheryl Panetta, Luc Kakkar, Fatima Piche, Dominique Viel‐Theriault, Isabelle Merckx, Joanna Lieberman, Lani
Abstract	AbstractIntroductionCoagulopathy and thrombosis associated with SARS‐CoV‐2 infection are well defined in hospitalized adults and leads to adverse outcomes. Pediatric studies are limited.MethodsAn international multicentered (n = 15) retrospective registry collected information on the clinical manifestations of SARS‐CoV‐2 and multisystem inflammatory syndrome (MIS‐C) in hospitalized children from February 1, 2020 through May 31, 2021. This sub‐study focused on coagulopathy. Study variables included patient demographics, comorbidities, clinical presentation, hospital course, laboratory parameters, management, and outcomes.ResultsNine hundred eighty‐five children were enrolled, of which 915 (93%) had clinical information available; 385 (42%) had symptomatic SARS‐CoV‐2 infection, 288 had MIS‐C (31.4%), and 242 (26.4%) had SARS‐CoV‐2 identified incidentally. Ten children (1%) experienced thrombosis, 16 (1.7%) experienced hemorrhage, and two (0.2%) experienced both thrombosis and hemorrhage. Significantly prevalent prothrombotic comorbidities included congenital heart disease (p‐value .007), respiratory support (p‐value .006), central venous catheter (CVC) (p = .04) in children with primary SARS‐CoV‐2 and in those with MIS‐C included respiratory support (p‐value .03), obesity (p‐value .002), and cytokine storm (p = .012). Comorbidities prevalent in children with hemorrhage included age >10 years (p = .04), CVC (p = .03) in children with primary SARS‐CoV‐2 infection and in those with MIS‐C encompassed thrombocytopenia (p = .001) and cytokine storm (p = .02). Eleven patients died (1.2%), with no deaths attributed to thrombosis or hemorrhage.ConclusionThrombosis and hemorrhage are uncommon events in children with SARS‐CoV‐2; largely experienced by those with pre‐existing comorbidities. Understanding the complete spectrum of coagulopathy in children with SARS‐CoV‐2 infection requires ongoing research.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC9350140&blobtype=pdf
Page Count	13
ISSN	15455009
Journal	Pediatric Blood & Cancer [Pediatr Blood Cancer]
Volume Number	69
DOI	10.1002/pbc.29793
PubMed Central reference number	PMC9350140
Issue Number	9
PubMed reference number	35689507
e-ISSN	15455017
Language	English
Publisher	John Wiley and Sons Inc.
Publisher Date	2022-06-11
Publisher Place	Hoboken
Access Restriction	Open
Rights License	This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency. © 2022 Wiley Periodicals LLC.
Subject Keyword	COVID‐19 hemorrhage MIS‐C pediatric SARS‐CoV‐2 thrombosis
Content Type	Text
Resource Type	Article
Subject	Hematology Pediatrics, Perinatology and Child Health Oncology