ABSTRACT
Background: Background The SARS-CoV- 2 infection has been associated with a potentially severe inflammatory reaction, endothelial damage, and coagulation cascade activation that cause thrombosis. There is limited information on the thrombosis and anticoagulant therapy in children with COVID-19 and no design pediatric-specific recommendations for thromboprophylaxis in COVID-19 are available. Aim(s): This study aims to evaluate the outcome of thromboprophylaxis in children less than 18-year- old with COVID-19 infection. Method(s): A retrospective study was conducted on 184 pediatric patients with confirmed COVID-19 infection in southern Iran. A designed questionnaire was made to collect all demographic, clinical, and laboratory data. According to World Health Organization, the patients were classified as asymptomatic/mild, moderate, severe, and critically ill. Result(s): The mean age of the patients was 7.04 +/- 5.9 (1 week to < 18 years), 96 boys and 88 girls. Overall, 33 patients received anticoagulant therapy. The median of D-dimer was insignificantly higher in patients taking anticoagulant therapy compared to another group. (P = 0.133). All variables were comparable between the two groups. The mortality rate was non-significantly higher in patients who were not treated with anticoagulants (14%) compared to the thromboprophylaxis group (9%) (P = 0.567). In the critical group, two patients were complicated with disseminated intravascular coagulation (2.56%), one patient (1.28%) with deep vein thrombosis despite taking thromboprophylaxis, and one (1.28%) with pulmonary thromboembolism while the patient did not take anticoagulant during hospital admission Table 1). Conclusion(s): Our data showed a lower rate of thrombosis (1.4% in moderate to severe/critically ill patients) than adult patients with COVID-19 infection. Moreover, higher mortality rate was observed in patients without anticoagulant therapy, though statistically not significant. It may underline the role of anticoagulants in moderate to severe/critically ill children with COVID-19 infection. Expert opinion and personal experience are necessary, while we have a significant knowledge gap in understanding COVID-19- associated coagulopathy and thrombotic risk in children. (Table Presented).