THROMBOTIC EVENTS IN CHILDREN AND ADOLESCENT PATIENTS WITH SARSCOV- 2 INFECTION: A SYSTEMATIC REVIEW WITH METANALYSIS ON INCIDENCE AND MANAGEMENT

ABSTRACT

Background and aims: Herein authors present a systematic review and metanalysis on the incidence of thrombotic events in pediatric and adolescent Sars-Cov-2 infection and the use of anticoagulant therapy in this age group. Methods: N 244 titles were screened using the elected MESH words, n 188 s and n 120 full text were read, n 12 articles were included, and among these last, four were included for metanalysis. Results: Over 1128 COVID-19 positive patients, nearly half of them developed inflammatory sequelae, and 7.35% developed thrombotic events. Less than half patients who developed inflammatory disease were under anticoagulant prophylactic treatment, and dosages of therapeutic anticoagulant protocols vary from different centres. Thrombotic events solved after the onset of unfractioned heprin (UFH) therapy in the majority of cases, even if 1.06% died. Two of these deaths had peripheral severe gangrene. No difference in the incidence of thrombotic events between patients under prophylactic low molecular weight heparin (LMWH) and without was found in metanalysis. Conclusions: Little is known on the incidence and management of hypercoagulopathy in pediatric COVID-19 infection;prophylactic doses of LMWH seem to be inefficient in preventing thrombotic events. Therapeutic dosed of UFH seem more efficient. Protocols on dosages have to be discussed. (Figure Presented).