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Objective:This study aimed to evaluate the adverse effects of hydroxy-chloroquine (HCQ) in children with COVID-19. Material and Methods: This study was conducted between March -August 2020 at a referral tertiary hospital for pediatric infectious diseases in the Aegean Region of Turkey. All hospitalized children with COVID-19 who were received HCQ include in this study. An electrocardiogram (ECG) was performed prior to the initiation of HCQ and at certain times (first and 24th hours of HCQ administration and two hours after the final dose of HCQ) during treatment. Adverse effects associated with HCQ were evaluated during the hospitalization and also the first and second months after discharge. Results: A total of 62 children with COVID-19 who administered HCQ treatment were evaluated. Of these, 35 (56.5%) were girls and 27 (43.5%) were boys. The mean age 13.7 +/- 3.0 years (range 6.0 to 18.0 years). Prior to the admission, none of the patients had arrhythmia, cardiovascular disease, or any cardiotoxic drugs usage. There was no abnormality on the baseline and following ECGs during the treatment with HCQ. Thir-teen patients had nausea (20.9%) and 10 patients (17.7%) had mild ab-dominal pain. None of the patients had no arrhythmia. Conclusion: No cardiac side effects were observed in our patients. How-ever, it is not possible to give a general statement on the safety data of HCQ therapy without any randomized controlled large-scale studies.
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Objectives COVID-19 and multisystem inflammatory syndrome in children (MIS-C) are associated with a risk of hypercoagulability and thrombotic events. We aimed (a) to evaluate the demographic, clinical, and laboratory findings as well as the incidence of thrombotic events of COVID-19 and MIS-C in children and (b) to determine the role of antithrombotic prophylaxis. Methods A single-center retrospective study evaluated hospitalized children with COVID-19 or MIS-C. Results The study group consisted of 690 patients, 596 (86.4%) diagnosed with COVID-19 and 94 (13.6%) diagnosed with MIS-C. Antithrombotic prophylaxis was used for 154 (22.3%) patients: 63 patients (10.6%) in the COVID-19 group and 91 (96.8%) patients in the MIS-C group. Use of antithrombotic prophylaxis was statistically higher in the MIS-C group (p<0.001). Patients who received antithrombotic prophylaxis were of older median age, were more commonly male, and had more frequent underlying diseases than those without prophylaxis (p<0.001, p<0.012, p<0.019, respectively). The most common underlying condition was obesity in patients who received antithrombotic prophylaxis. Thrombosis was observed in one (0.2%) patient in the COVID-19 group with a thrombus in the cephalic vein, two (2.1%) patients in the MIS-C group, with a dural thrombus in one patient and a cardiac thrombus in the other patient. The patients with thrombotic events were previously healthy and had mild disease. Conclusion In our study, thrombotic events were rare compared with previous reports. We used antithrombotic prophylaxis for most children with underlying risk factors;perhaps for this reason, we did not observe thrombotic events in children with underlying risk factors. We suggest that patients diagnosed with COVID-19 or MIS-C be closely monitored for thrombotic events.
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OBJECTIVES: COVID-19 and multisystem inflammatory syndrome in children (MIS-C) are associated with a risk of hypercoagulability and thrombotic events. We aimed (a) to evaluate the demographic, clinical, and laboratory findings as well as the incidence of thrombotic events of COVID-19 and MIS-C in children and (b) to determine the role of antithrombotic prophylaxis. METHODS: A single-center retrospective study evaluated hospitalized children with COVID-19 or MIS-C. RESULTS: The study group consisted of 690 patients, 596 (86.4%) diagnosed with COVID-19 and 94 (13.6%) diagnosed with MIS-C. Antithrombotic prophylaxis was used for 154 (22.3%) patients: 63 patients (10.6%) in the COVID-19 group and 91 (96.8%) patients in the MIS-C group. Use of antithrombotic prophylaxis was statistically higher in the MIS-C group (p<0.001). Patients who received antithrombotic prophylaxis were of older median age, were more commonly male, and had more frequent underlying diseases than those without prophylaxis (p<0.001, p<0.012, p<0.019, respectively). The most common underlying condition was obesity in patients who received antithrombotic prophylaxis. Thrombosis was observed in one (0.2%) patient in the COVID-19 group with a thrombus in the cephalic vein, two (2.1%) patients in the MIS-C group, with a dural thrombus in one patient and a cardiac thrombus in the other patient. The patients with thrombotic events were previously healthy and had mild disease. CONCLUSION: In our study, thrombotic events were rare compared with previous reports. We used antithrombotic prophylaxis for most children with underlying risk factors; perhaps for this reason, we did not observe thrombotic events in children with underlying risk factors. We suggest that patients diagnosed with COVID-19 or MIS-C be closely monitored for thrombotic events.
Subject(s)
COVID-19 , Thrombosis , Humans , Child , Male , COVID-19/complications , Fibrinolytic Agents , Retrospective Studies , Thrombosis/etiology , Thrombosis/prevention & controlABSTRACT
Objective: This study aimed to evaluate the adverse effects of hydroxychloroquine (HCQ) in children with COVID-19. Material and Methods: This study was conducted between March- August 2020 at a referral tertiary hospital for pediatric infectious diseases in the Aegean Region of Turkey. All hospitalized children with COVID-19 who were received HCQ include in this study. An electrocardiogram (ECG) was performed prior to the initiation of HCQ and at certain times (first and 24th hours of HCQ administration and two hours after the final dose of HCQ) during treatment. Adverse effects associated with HCQ were evaluated during the hospitalization and also the first and second months after discharge.
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Objective: There is currently no drug that is effective against the coronavirus disease-2019 (COVID-19) and no consensus was present regarding the treatment. In this cross-sectional study, we aimed to evaluate the progress of the treatment process of patients with COVID-19 since the first day of pandemic in our country and the changes in the process. Method: This single-center cross-sectional study was conducted from March 11 through November 30, 2020, in University of Health Sciences Turkey, Dr. Behcet Uz Pediatric Diseases and Surgery Training and Research Hospital, a 400-bed tertiary care hospital in Izmir, Turkey. Treatment options in all hospitalized children with COVID-19 were evaluated.
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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.
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Objective: SARS-CoV-2, emerged in December 2019 in the city of Wuhan in the People's Republic of China affects children as well as all age groups. The aim of the study was to evaluate the clinical features and outcomes of pediatric cases with COVID-19 in the first month of the epidemic in Turkey. Method: This single center cross-sectional study was conducted in University of Health Sciences Dr Behcet Uz Child Diseases and Pediatric Surgery Training and Research Hospital during the period of March 11 - April 20, 2020. Demographic, epidemiological and clinical data were collected from medical records. All patients were confirmed by real time reverse transcription- polymerase chain reaction. Chidren were classified as asymptomatic, mild, moderate, severe, and critically ill patients. Results: In this study, we reported the clinical characteristics of a case series involving 30 chilren with COVID-19 aged from 23 days to 16 years. Twenty-nine (96.7%) patients had confirmed contact with family members for COVID-19. The majority of patients were asymptomatic (50%) or had mild symptoms (26.7%). Fever (46.6%) and cough (33.3%) were the most common symptoms. Conclusion: Our study indicated that COVID 19 in children exhibited less severe symptoms and had better outcomes