Coagulation profiles and viscoelastic testing in multisystem inflammatory syndrome in children.
Pediatr Blood Cancer
; 68(12): e29355, 2021 12.
Article
in English
| MEDLINE | ID: covidwho-1414402
ABSTRACT
OBJECTIVE:
To characterize viscoelastic testing profiles of children with multisystem inflammatory syndrome in children (MIS-C).METHODS:
This single-center retrospective review included 30 patients diagnosed with MIS-C from March 1 to September 1, 2020. Thromboelastography (TEG) with platelet mapping was performed in 19 (63%) patients and compared to age- and sex-matched controls prior to cardiac surgery. Relationships between TEG parameters and inflammatory markers were assessed using correlation.RESULTS:
Patients with MIS-C had abnormal TEG results compared to controls, including decreased kinetic (K) time (1.1 vs. 1.7 minutes, p < .01), increased alpha angle (75.0° vs. 65.7°, p < .01), increased maximum amplitude (70.8 vs. 58.3 mm, p < .01), and decreased lysis in 30 minutes (Ly30) (1.1% vs. 3.7%, p = .03); consistent with increased clot formation rate and strength, and reduced fibrinolysis. TEG maximum amplitude was moderately correlated with erythrocyte sedimentation rate (ESR) (r = 0.60, p = .02), initial platelet count (r = 0.67, p < .01), and peak platelet count (r = 0.51, p = .03). TEG alpha angle was moderately correlated with peak platelet count (r = 0.54, p = .02). Seventeen (57%) patients received aspirin (ASA) and anticoagulation, five (17%) received only ASA, and three (10%) received only anticoagulation. No patients had a symptomatic thrombotic event. Six (20%) patients had a bleeding event, none of which was major.CONCLUSIONS:
Patients with MIS-C had evidence of hypercoagulability on TEG. Increased ESR and platelets were associated with higher clot strength. Patients were prophylactically treated with ASA or anticoagulation with no symptomatic thrombosis or major bleeding. Further multicenter study is required to characterize the rate of thrombosis and optimal thromboprophylaxis algorithm in this patient population.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Blood Coagulation
/
Systemic Inflammatory Response Syndrome
/
Thrombophilia
/
COVID-19
Type of study:
Experimental Studies
/
Observational study
Topics:
Long Covid
Limits:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Male
Language:
English
Journal:
Pediatr Blood Cancer
Journal subject:
Hematology
/
Neoplasms
/
Pediatrics
Year:
2021
Document Type:
Article
Affiliation country:
Pbc.29355
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