Incidence and Risk of Pulmonary Embolism in Pediatric Patients with Acute Covid-19 Infection

ABSTRACT

INTRODUCTION: Previous studies have reported an increased risk of procoagulant events such as pulmonary embolism (PE) in adult patients with Coronavirus Disease-19 (COVID-19). However, scant information exists within pediatric samples. This study aimed to investigate the effect of COVID-19 acute infections on the incidence of PE among pediatric patients. METHOD(S) Using Virtual Pediatric Systems (VPS), retrospective data was collected of patients age < 18 years old who were admitted to participating pediatric critical care units from 2018-2021. Patients with an ICD diagnosis of COVID-19 infection or PE were extracted for further analysis. Additional information regarding patient age, gender, race, BMI, comorbidities were also obtained. RESULT(S) In total, there were 488,298 admissions to PICUS participating in VPS from 2018 - 2021. In 2018 and 2019, prior to the COVID-19 pandemic, the incidence of PE among the pediatric population was 2.29 per 1000 patients (n=614). During the COVID-19 pandemic in 2020-2021, the incidence of PE increased to 3.11 per 1000 patients (n=686). Of the PE cases between 2020 to 2021, 12.1% (n=83) patients had an acute COVID-19 infection (53.0% female;42.0% BMI> 35;91.6% >12 years of age;92.8% survival). Patients with acute COVID-19 infection had 3.4 (95% CI, 2.7 - 4.2) times the risk of pulmonary embolism than patients from 2020 to 2021 without acute COVID-19 infection. CONCLUSION(S) In this study, we report an increased incidence of PE among pediatric patients during the COVID-19 pandemic when compared with the years prior to the pandemic. Additionally, we report a significantly increased relative risk of pulmonary embolism in patients with acute COVID-19 infection compared to patients without acute COVID-19 infection. Further analysis is planned to adjust for hypercoagulable states. Additional research is needed to identify risk factors for PE in pediatric patients with COVID-19.