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Guner Ozenen G, Akaslan Kara A, Boncuoglu E, Kiymet E, Cem E, Sahinkaya S, Yilmaz Celebi M, Gulderen M, Kacar P, Uras M, Hilkay Karapinar T, Oymak Y, Bayram N, Devrim I. Evaluation of antithrombotic prophylaxis and thrombotic events in children with COVID-19 or MIS-C: A tertiary pediatric center experience. Arch Pediatr 2023; 30:172-178. [PMID: 36907731 PMCID: PMC9902296 DOI: 10.1016/j.arcped.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 08/26/2022] [Accepted: 01/15/2023] [Indexed: 02/09/2023]
Abstract
OBJECTIVES COVID-19 and multisystem inflammatory syndrome in children (MIS-C) are associated with a risk of hypercoagulability and thrombotic events. We aimed (a) to evaluate the demographic, clinical, and laboratory findings as well as the incidence of thrombotic events of COVID-19 and MIS-C in children and (b) to determine the role of antithrombotic prophylaxis. METHODS A single-center retrospective study evaluated hospitalized children with COVID-19 or MIS-C. RESULTS The study group consisted of 690 patients, 596 (86.4%) diagnosed with COVID-19 and 94 (13.6%) diagnosed with MIS-C. Antithrombotic prophylaxis was used for 154 (22.3%) patients: 63 patients (10.6%) in the COVID-19 group and 91 (96.8%) patients in the MIS-C group. Use of antithrombotic prophylaxis was statistically higher in the MIS-C group (p<0.001). Patients who received antithrombotic prophylaxis were of older median age, were more commonly male, and had more frequent underlying diseases than those without prophylaxis (p<0.001, p<0.012, p<0.019, respectively). The most common underlying condition was obesity in patients who received antithrombotic prophylaxis. Thrombosis was observed in one (0.2%) patient in the COVID-19 group with a thrombus in the cephalic vein, two (2.1%) patients in the MIS-C group, with a dural thrombus in one patient and a cardiac thrombus in the other patient. The patients with thrombotic events were previously healthy and had mild disease. CONCLUSION In our study, thrombotic events were rare compared with previous reports. We used antithrombotic prophylaxis for most children with underlying risk factors; perhaps for this reason, we did not observe thrombotic events in children with underlying risk factors. We suggest that patients diagnosed with COVID-19 or MIS-C be closely monitored for thrombotic events.
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Affiliation(s)
- G Guner Ozenen
- Department of Pediatric Infectious Diseases, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey.
| | - A Akaslan Kara
- Department of Pediatric Infectious Diseases, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - E Boncuoglu
- Department of Pediatric Infectious Diseases, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - E Kiymet
- Department of Pediatric Infectious Diseases, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - E Cem
- Department of Pediatric Infectious Diseases, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - S Sahinkaya
- Department of Pediatric Infectious Diseases, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - M Yilmaz Celebi
- Department of Pediatric Infectious Diseases, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - M Gulderen
- Department of Pediatric Infectious Diseases, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - P Kacar
- Department of Pediatric Infectious Diseases, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - M Uras
- Department of Pediatrics, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - T Hilkay Karapinar
- Department of Pediatric Hematology and Oncology, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Y Oymak
- Department of Pediatric Hematology and Oncology, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - N Bayram
- Department of Pediatric Infectious Diseases, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - I Devrim
- Department of Pediatric Infectious Diseases, University of Health Sciences, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
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Kurt Y, Akin ML, Demirbas S, Uluutku AH, Gulderen M, Avsar K, Celenk T. D-Dimer in the Early Diagnosis of Acute Mesenteric Ischemia Secondary to Arterial Occlusion in Rats. Eur Surg Res 2008; 37:216-9. [PMID: 16260871 DOI: 10.1159/000087866] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2005] [Accepted: 07/27/2005] [Indexed: 01/10/2023]
Abstract
BACKGROUND Early diagnosis of mesenteric ischemia can be life saving. The aim of this study is to investigate the time-dependent diagnostic value of plasma D-dimer and other ancillary laboratory evaluations such as creatine phosphokinase, lactic dehydrogenase, aspartate aminotransferase, alanine aminotransferase, amylase, and leukocyte count in an experimental superior mesenteric arterial occlusion (SMA-O) model in rats. METHODS Forty male Wistar-Albino rats were separated into 4 groups: 2-, 4-, 6-, and 12-hour SMA-O groups. After laparotomy, the SMA was identified and ligated for 2, 4, 6 and 12 h in the 4 respective study groups. Blood samples were taken for laboratory tests 2 h after laparotomy in the control group and at the end of the ischemic period in the study groups. RESULTS The longer the duration of mesenteric ischemia, the higher were the serum D-dimer levels in the study groups, and statistical significance was obtained at 2 h (p = 0.021). Sensitivity, positive predictive value, negative predictive value, and accuracy of the relation were 88.8, 88.8, 100 and 90%, respectively. Leukocyte count was significantly higher than controls after 12 h. No other laboratory parameter correlated positively with the duration of mesenteric ischemia. CONCLUSION Serum D-dimer measurements may be a valuable diagnostic parameter in the early diagnosis of mesenteric ischemia.
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Affiliation(s)
- Y Kurt
- Department of General Surgery, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
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