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Association between Coagulation Profile and Clinical Outcome in Children with SARS-CoV-2 Infection or MIS-C: A Multicenter Cross-Sectional Study

Limited data on the coagulation profile in children affected by the SARS-CoV-2 infection are available. We aimed to evaluate the role of d-dimers as predictors of poor outcomes in a pediatric population affected by the SARS-CoV-2 infection or multisystem inflammatory syndrome (MIS-C). We performed a...

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Autores principales: Buonsenso, Danilo, Mariani, Francesco, Pierri, Luca, Morello, Rosa, Yock-Corrales, Adriana, Del Aguila, Olguita, Lazzareschi, Ilaria, Zampino, Giuseppe, Nunziata, Francesco, Valentini, Piero, Lo Vecchio, Andrea
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870084/
https://www.ncbi.nlm.nih.gov/pubmed/35204999
http://dx.doi.org/10.3390/children9020279
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author Buonsenso, Danilo
Mariani, Francesco
Pierri, Luca
Morello, Rosa
Yock-Corrales, Adriana
Del Aguila, Olguita
Lazzareschi, Ilaria
Zampino, Giuseppe
Nunziata, Francesco
Valentini, Piero
Lo Vecchio, Andrea
author_facet Buonsenso, Danilo
Mariani, Francesco
Pierri, Luca
Morello, Rosa
Yock-Corrales, Adriana
Del Aguila, Olguita
Lazzareschi, Ilaria
Zampino, Giuseppe
Nunziata, Francesco
Valentini, Piero
Lo Vecchio, Andrea
author_sort Buonsenso, Danilo
collection PubMed
description Limited data on the coagulation profile in children affected by the SARS-CoV-2 infection are available. We aimed to evaluate the role of d-dimers as predictors of poor outcomes in a pediatric population affected by the SARS-CoV-2 infection or multisystem inflammatory syndrome (MIS-C). We performed a retrospective cross-sectional multicenter study. Data from four different centers were collected. Laboratory tests, when performed, were collected at the time of diagnosis, and 24, 48, 72, 96, 120 and beyond 120 h from diagnosis; blood counts with formula, an international normalized ratio (INR), activated partial thromboplastin time (aPTT), D-dimers and fibrinogen values were collected. Data regarding clinical history, management and outcome of the patients were also collected. Three hundred sixteen patients with a median age of 3.93 years (IQR 0.62–10.7) diagnosed with COVID-19 or MIS-C were enrolled. Fifty-eight patients (18.3%) showed a severe clinical outcome, 13 (4.1%) developed sequelae and 3 (0.9%) died. The univariate analysis showed that age, high D-dimer values, hyperfibrinogenemia, INR and aPTT elongation, and low platelet count were associated with an increased risk of pediatric intensive care unit (PICU) admission (p < 0.01). Three multivariate logistic regressions showed that a d-dimer level increase was associated with a higher risk of PICU admission. This study shows that D-dimer values play an important role in predicting the more severe spectrum of the SARS-CoV-2 infection, and was higher also in those that developed sequelae, including long COVID-19.
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spelling pubmed-88700842022-02-25 Association between Coagulation Profile and Clinical Outcome in Children with SARS-CoV-2 Infection or MIS-C: A Multicenter Cross-Sectional Study Buonsenso, Danilo Mariani, Francesco Pierri, Luca Morello, Rosa Yock-Corrales, Adriana Del Aguila, Olguita Lazzareschi, Ilaria Zampino, Giuseppe Nunziata, Francesco Valentini, Piero Lo Vecchio, Andrea Children (Basel) Article Limited data on the coagulation profile in children affected by the SARS-CoV-2 infection are available. We aimed to evaluate the role of d-dimers as predictors of poor outcomes in a pediatric population affected by the SARS-CoV-2 infection or multisystem inflammatory syndrome (MIS-C). We performed a retrospective cross-sectional multicenter study. Data from four different centers were collected. Laboratory tests, when performed, were collected at the time of diagnosis, and 24, 48, 72, 96, 120 and beyond 120 h from diagnosis; blood counts with formula, an international normalized ratio (INR), activated partial thromboplastin time (aPTT), D-dimers and fibrinogen values were collected. Data regarding clinical history, management and outcome of the patients were also collected. Three hundred sixteen patients with a median age of 3.93 years (IQR 0.62–10.7) diagnosed with COVID-19 or MIS-C were enrolled. Fifty-eight patients (18.3%) showed a severe clinical outcome, 13 (4.1%) developed sequelae and 3 (0.9%) died. The univariate analysis showed that age, high D-dimer values, hyperfibrinogenemia, INR and aPTT elongation, and low platelet count were associated with an increased risk of pediatric intensive care unit (PICU) admission (p < 0.01). Three multivariate logistic regressions showed that a d-dimer level increase was associated with a higher risk of PICU admission. This study shows that D-dimer values play an important role in predicting the more severe spectrum of the SARS-CoV-2 infection, and was higher also in those that developed sequelae, including long COVID-19. MDPI 2022-02-17 /pmc/articles/PMC8870084/ /pubmed/35204999 http://dx.doi.org/10.3390/children9020279 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Buonsenso, Danilo
Mariani, Francesco
Pierri, Luca
Morello, Rosa
Yock-Corrales, Adriana
Del Aguila, Olguita
Lazzareschi, Ilaria
Zampino, Giuseppe
Nunziata, Francesco
Valentini, Piero
Lo Vecchio, Andrea
Association between Coagulation Profile and Clinical Outcome in Children with SARS-CoV-2 Infection or MIS-C: A Multicenter Cross-Sectional Study
title Association between Coagulation Profile and Clinical Outcome in Children with SARS-CoV-2 Infection or MIS-C: A Multicenter Cross-Sectional Study
title_full Association between Coagulation Profile and Clinical Outcome in Children with SARS-CoV-2 Infection or MIS-C: A Multicenter Cross-Sectional Study
title_fullStr Association between Coagulation Profile and Clinical Outcome in Children with SARS-CoV-2 Infection or MIS-C: A Multicenter Cross-Sectional Study
title_full_unstemmed Association between Coagulation Profile and Clinical Outcome in Children with SARS-CoV-2 Infection or MIS-C: A Multicenter Cross-Sectional Study
title_short Association between Coagulation Profile and Clinical Outcome in Children with SARS-CoV-2 Infection or MIS-C: A Multicenter Cross-Sectional Study
title_sort association between coagulation profile and clinical outcome in children with sars-cov-2 infection or mis-c: a multicenter cross-sectional study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870084/
https://www.ncbi.nlm.nih.gov/pubmed/35204999
http://dx.doi.org/10.3390/children9020279
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