Thromboprophylaxis for Coagulopathy Related to COVID-19 in Pediatrics: A Narrative Review

Overview

Journal Paediatr Drugs

Specialties Pediatrics
Pharmacology

Date 2023 May 4

PMID 37142896

Authors

Hadi Sahrai

Mahdi Hemmati-Ghavshough

Marzieh Shahrabi

Amir Hossein Jafari-Rouhi

Mohammad Solduzian

Affiliations

Soon will be listed here.

Abstract

In addition to harming the respiratory system, COVID-19 can affect multiple organs. Children may develop a specific complication of COVID-19 called multisystem inflammatory syndrome in children (MIS-C) which could influence the vascular system of children and cause multiple coagulopathies in the body. Information on the use of thromboprophylaxis in this condition was collected via the review of various articles. In general, different factors in immune system responses can trigger the initiation of thrombotic events. Studies have shown that starting anticoagulant prophylaxis, which contributes to decreased thrombotic events, is dependent on the patient's condition and D-dimer levels. However, further studies on pediatric populations are needed to establish the role of anticoagulants in children with this condition.

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References

Whitworth H, Sartain S, Kumar R, Armstrong K, Ballester L, Betensky M . Rate of thrombosis in children and adolescents hospitalized with COVID-19 or MIS-C. Blood. 2021; 138(2):190-198. PMC: 8079262. DOI: 10.1182/blood.2020010218. View

Goldenberg N, Sochet A, Albisetti M, Biss T, Bonduel M, Jaffray J . Consensus-based clinical recommendations and research priorities for anticoagulant thromboprophylaxis in children hospitalized for COVID-19-related illness. J Thromb Haemost. 2020; 18(11):3099-3105. PMC: 9906345. DOI: 10.1111/jth.15073. View

Jiang L, Tang K, Levin M, Irfan O, Morris S, Wilson K . COVID-19 and multisystem inflammatory syndrome in children and adolescents. Lancet Infect Dis. 2020; 20(11):e276-e288. PMC: 7431129. DOI: 10.1016/S1473-3099(20)30651-4. View

Diorio C, Henrickson S, Vella L, McNerney K, Chase J, Burudpakdee C . Multisystem inflammatory syndrome in children and COVID-19 are distinct presentations of SARS-CoV-2. J Clin Invest. 2020; 130(11):5967-5975. PMC: 7598044. DOI: 10.1172/JCI140970. View

Al-Ghafry M, Aygun B, Appiah-Kubi A, Vlachos A, Ostovar G, Capone C . Are children with SARS-CoV-2 infection at high risk for thrombosis? Viscoelastic testing and coagulation profiles in a case series of pediatric patients. Pediatr Blood Cancer. 2020; 67(12):e28737. PMC: 7645957. DOI: 10.1002/pbc.28737. View

Feldstein L, Rose E, Horwitz S, Collins J, Newhams M, Son M . Multisystem Inflammatory Syndrome in U.S. Children and Adolescents. N Engl J Med. 2020; 383(4):334-346. PMC: 7346765. DOI: 10.1056/NEJMoa2021680. View

Suh Y, Hong H, Ohana M, Bompard F, Revel M, Valle C . Pulmonary Embolism and Deep Vein Thrombosis in COVID-19: A Systematic Review and Meta-Analysis. Radiology. 2020; 298(2):E70-E80. PMC: 7745997. DOI: 10.1148/radiol.2020203557. View

Zhang Y, Cao W, Jiang W, Xiao M, Li Y, Tang N . Profile of natural anticoagulant, coagulant factor and anti-phospholipid antibody in critically ill COVID-19 patients. J Thromb Thrombolysis. 2020; 50(3):580-586. PMC: 7346854. DOI: 10.1007/s11239-020-02182-9. View

Cattaneo M, Bertinato E, Birocchi S, Brizio C, Malavolta D, Manzoni M . Pulmonary Embolism or Pulmonary Thrombosis in COVID-19? Is the Recommendation to Use High-Dose Heparin for Thromboprophylaxis Justified?. Thromb Haemost. 2020; 120(8):1230-1232. PMC: 7516356. DOI: 10.1055/s-0040-1712097. View

10.

Gupta N, Zhao Y, Evans C . The stimulation of thrombosis by hypoxia. Thromb Res. 2019; 181:77-83. DOI: 10.1016/j.thromres.2019.07.013. View

11.

Kerr R, Stirling D, Ludlam C . Interleukin 6 and haemostasis. Br J Haematol. 2001; 115(1):3-12. DOI: 10.1046/j.1365-2141.2001.03061.x. View

12.

Page M, Bester J, Pretorius E . The inflammatory effects of TNF-α and complement component 3 on coagulation. Sci Rep. 2018; 8(1):1812. PMC: 5789054. DOI: 10.1038/s41598-018-20220-8. View

13.

McGonagle D, ODonnell J, Sharif K, Emery P, Bridgewood C . Immune mechanisms of pulmonary intravascular coagulopathy in COVID-19 pneumonia. Lancet Rheumatol. 2020; 2(7):e437-e445. PMC: 7252093. DOI: 10.1016/S2665-9913(20)30121-1. View

14.

Aronoff S, Hall A, Del Vecchio M . The Natural History of Severe Acute Respiratory Syndrome Coronavirus 2-Related Multisystem Inflammatory Syndrome in Children: A Systematic Review. J Pediatric Infect Dis Soc. 2020; 9(6):746-751. PMC: 7797745. DOI: 10.1093/jpids/piaa112. View

15.

Oudkerk M, Buller H, Kuijpers D, van Es N, Oudkerk S, McLoud T . Diagnosis, Prevention, and Treatment of Thromboembolic Complications in COVID-19: Report of the National Institute for Public Health of the Netherlands. Radiology. 2020; 297(1):E216-E222. PMC: 7233406. DOI: 10.1148/radiol.2020201629. View

16.

Appel I, Grimminck B, Geerts J, Stigter R, Cnossen M, Beishuizen A . Age dependency of coagulation parameters during childhood and puberty. J Thromb Haemost. 2012; 10(11):2254-63. DOI: 10.1111/j.1538-7836.2012.04905.x. View

17.

Biswas I, Khan G . Coagulation Disorders in COVID-19: Role of Toll-like Receptors. J Inflamm Res. 2020; 13:823-828. PMC: 7605922. DOI: 10.2147/JIR.S271768. View

18.

Nutescu E, Burnett A, Fanikos J, Spinler S, Wittkowsky A . Pharmacology of anticoagulants used in the treatment of venous thromboembolism. J Thromb Thrombolysis. 2016; 41(1):15-31. PMC: 4715843. DOI: 10.1007/s11239-015-1314-3. View

19.

Sochet A, Morrison J, Jaffray J, Godiwala N, Wilson H, Thornburg C . Enoxaparin Thromboprophylaxis in Children Hospitalized for COVID-19: A Phase 2 Trial. Pediatrics. 2022; 150(1). DOI: 10.1542/peds.2022-056726. View

20.

Del Borrello G, Giraudo I, Bondone C, Denina M, Garazzino S, Linari C . SARS-COV-2-associated coagulopathy and thromboembolism prophylaxis in children: A single-center observational study. J Thromb Haemost. 2020; 19(2):522-530. PMC: 9906296. DOI: 10.1111/jth.15216. View