Sharathkumar Anjali A, Faustino E Vincent S, Takemoto Clifford M
Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA.
Section of Pediatric Critical Care Medicine, Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut, USA.
Pediatr Blood Cancer. 2021 Jul;68(7):e29049. doi: 10.1002/pbc.29049. Epub 2021 May 6.
Thrombosis within the microvasculature and medium to large vessels is a serious and common complication among critically ill individuals with coronavirus disease 2019 (COVID-19). While children are markedly less likely to develop severe disease than adults, they remain at risk for thrombosis during acute infection and with the post-acute inflammatory illness termed multisystem inflammatory syndrome in children. Significant knowledge deficits in understanding COVID-19-associated coagulopathy and thrombotic risk pose clinical challenges for pediatric providers who must incorporate expert opinion and personal experience to manage individual patients. We discuss clinical scenarios to provide framework for characterizing thrombosis risk and thromboprophylaxis in children with COVID-19.
在患有2019冠状病毒病(COVID-19)的危重症患者中,微血管以及中大型血管内的血栓形成是一种严重且常见的并发症。虽然儿童患重症的可能性明显低于成人,但在急性感染期间以及在被称为儿童多系统炎症综合征的急性后炎症性疾病期间,他们仍有血栓形成的风险。在理解与COVID-19相关的凝血病和血栓形成风险方面存在重大知识空白,这给儿科医疗人员带来了临床挑战,他们必须结合专家意见和个人经验来管理个体患者。我们讨论临床案例,为描述COVID-19患儿的血栓形成风险和血栓预防提供框架。