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Thrombotic risk in children with COVID-19 infection: A systematic review of the literature

OBJECTIVE: Coagulation and inflammatory parameters are mildly altered in children with SARS-CoV-2 (COVID-19) infection, and laboratory evidence of a proinflammatory and procoagulant state has been noted in multisystem inflammatory syndrome in children (MIS-C). It is not clear whether this pediatric...

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Autores principales: Zaffanello, Marco, Piacentini, Giorgio, Nosetti, Luana, Ganzarolli, Stefania, Franchini, Massimo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Ltd. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8284063/
https://www.ncbi.nlm.nih.gov/pubmed/34293539
http://dx.doi.org/10.1016/j.thromres.2021.07.011
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author Zaffanello, Marco
Piacentini, Giorgio
Nosetti, Luana
Ganzarolli, Stefania
Franchini, Massimo
author_facet Zaffanello, Marco
Piacentini, Giorgio
Nosetti, Luana
Ganzarolli, Stefania
Franchini, Massimo
author_sort Zaffanello, Marco
collection PubMed
description OBJECTIVE: Coagulation and inflammatory parameters are mildly altered in children with SARS-CoV-2 (COVID-19) infection, and laboratory evidence of a proinflammatory and procoagulant state has been noted in multisystem inflammatory syndrome in children (MIS-C). It is not clear whether this pediatric condition is related to thrombotic events. With this study we reviewed the literature for thrombotic complications in children with COVID-19 infection and MIS-C. DATA SOURCES: We searched the Medline PubMed Advanced Search Builder, Scopus, Web Of Science, and Google Scholar electronic databases (until 1 January 2021) using the medical subject headings (MeSH) terms and text words (their combinations and truncated synonyms): (THROMBOSIS OR THROMBOPHILIA) AND (CHILD OR CHILDREN OR INFANT) AND (COVID-19 OR SARS-CoV-2). STUDY ELIGIBILITY CRITERIA: Inclusion criteria were children with COVID-19 or SARS-COV-2 infection. The search was limited to articles published in English. Exclusion criteria were: reviews of published studies, studies published only as abstracts, letters or conference proceedings, discussion papers, animal studies, or editorials. RESULTS: After screening for duplicates, the initial search yielded 86 records: 12 were case reports involving 19 children; comorbidities were absent or mild in 73.7%. The most common site of thrombosis the lung (21%); the most often used drug was heparin (42%). Two studies were an international survey (n = 337 patients) and a large multicenter study (n = 186 patients with MIS-C). The risk of ischemic stroke in SARS-CoV-2 infection (0.82%) and deep venous thrombosis in MIS-C (4.3%) was lower in children than in adults. CONCLUSIONS: Thrombodic or thromboembolic events are rare in pediatric patients with COVID-19 infection and MIS-C. Nonetheless, as in adults, a high index of suspicion should be maintained in children with COVID-19 infection or MIS-C, particularly in those with comorbidities predisposing to thrombotic events.
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spelling pubmed-82840632021-07-20 Thrombotic risk in children with COVID-19 infection: A systematic review of the literature Zaffanello, Marco Piacentini, Giorgio Nosetti, Luana Ganzarolli, Stefania Franchini, Massimo Thromb Res Review Article OBJECTIVE: Coagulation and inflammatory parameters are mildly altered in children with SARS-CoV-2 (COVID-19) infection, and laboratory evidence of a proinflammatory and procoagulant state has been noted in multisystem inflammatory syndrome in children (MIS-C). It is not clear whether this pediatric condition is related to thrombotic events. With this study we reviewed the literature for thrombotic complications in children with COVID-19 infection and MIS-C. DATA SOURCES: We searched the Medline PubMed Advanced Search Builder, Scopus, Web Of Science, and Google Scholar electronic databases (until 1 January 2021) using the medical subject headings (MeSH) terms and text words (their combinations and truncated synonyms): (THROMBOSIS OR THROMBOPHILIA) AND (CHILD OR CHILDREN OR INFANT) AND (COVID-19 OR SARS-CoV-2). STUDY ELIGIBILITY CRITERIA: Inclusion criteria were children with COVID-19 or SARS-COV-2 infection. The search was limited to articles published in English. Exclusion criteria were: reviews of published studies, studies published only as abstracts, letters or conference proceedings, discussion papers, animal studies, or editorials. RESULTS: After screening for duplicates, the initial search yielded 86 records: 12 were case reports involving 19 children; comorbidities were absent or mild in 73.7%. The most common site of thrombosis the lung (21%); the most often used drug was heparin (42%). Two studies were an international survey (n = 337 patients) and a large multicenter study (n = 186 patients with MIS-C). The risk of ischemic stroke in SARS-CoV-2 infection (0.82%) and deep venous thrombosis in MIS-C (4.3%) was lower in children than in adults. CONCLUSIONS: Thrombodic or thromboembolic events are rare in pediatric patients with COVID-19 infection and MIS-C. Nonetheless, as in adults, a high index of suspicion should be maintained in children with COVID-19 infection or MIS-C, particularly in those with comorbidities predisposing to thrombotic events. Elsevier Ltd. 2021-09 2021-07-16 /pmc/articles/PMC8284063/ /pubmed/34293539 http://dx.doi.org/10.1016/j.thromres.2021.07.011 Text en © 2021 Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Review Article
Zaffanello, Marco
Piacentini, Giorgio
Nosetti, Luana
Ganzarolli, Stefania
Franchini, Massimo
Thrombotic risk in children with COVID-19 infection: A systematic review of the literature
title Thrombotic risk in children with COVID-19 infection: A systematic review of the literature
title_full Thrombotic risk in children with COVID-19 infection: A systematic review of the literature
title_fullStr Thrombotic risk in children with COVID-19 infection: A systematic review of the literature
title_full_unstemmed Thrombotic risk in children with COVID-19 infection: A systematic review of the literature
title_short Thrombotic risk in children with COVID-19 infection: A systematic review of the literature
title_sort thrombotic risk in children with covid-19 infection: a systematic review of the literature
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8284063/
https://www.ncbi.nlm.nih.gov/pubmed/34293539
http://dx.doi.org/10.1016/j.thromres.2021.07.011
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