Document Type : original article
Authors
- Arian Karimi Rouzbahani 1
- Samaneh Tahmasebi Ghorabi 2
- Maryam Mohammadian 3
- Maliheh Mohammad Zadeh 4
- Zahra Goudarzi 5
- Mahmood Mallahi 6
- Mohammad Ali Molavi 7
1 USERN Office, Lorestan University of Medical Sciences, Khorramabad, Iran Student Research committee, Lorestan University of Medical Sciences, Khorramabad, Iran
2 Master Health Education, Ilam University of Medical Sciences, Ilam, Iran
3 Department of Pediatric, Clinical Research Development Center of Children Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
4 Department of Pediatrics, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
5 Bachelor of Nursing Student, scientific Research of Committee, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
6 Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
7 Department of Pediatric Oncology, pediatric Hospital, GolShahr, Bandar Abbas, Iran
Abstract
Background: Based on the findings of previous studies, patients with severe Covid-19 have a much greater occurrence of coagulation abnormalities. Additionally, individuals who get this novel virus are susceptible to developing disseminated intravascular coagulation. The present study aimed to investigate the frequency of coagulation disorders in children with covid-19 who were hospitalized in Bandar Abbas Children's Hospital during 2020-2021.
Methods: This study was done retrospectively. The medical records of all children were checked with a definite diagnosis of Covid-19, based on positive PCR results. Age, gender and comorbidity status were obtained from the medical records of the patients. In addition, white blood cell count, blood platelet count, hemoglobin concentration, CRP, PT, PTT, INR, D-dimer and fibrinogen were checked. Data was analyzed using SPSS 22 software with a significance threshold of 0.05.
Results: In this study 20.63% had coagulation abnormalities. The groups with and without coagulation disease exhibited a significant difference in the proportions of neutrophils and lymphocytes. Specifically, the coagulation disorder group had elevated levels of neutrophils and reduced levels of lymphocytes (P= 0.043, P= 0.041, respectively). The average D-dimer level and age in the group with coagulation disorder was significantly greater than those in the group without coagulation problem (P= 0.000, P=0.045).
Conclusion: According to the findings of this research, 20.63% of children who were definitively diagnosed with covid-19 had coagulation abnormalities. Only the alterations in D-dimer, lymphocyte, and neutrophil levels were shown to be substantially associated with coagulation disorders in this investigation. Specifically, in the group with coagulation disorders, there was an elevation in neutrophil count and a decrease in lymphocyte count.
Keywords
- Jiang H-j, Nan J, Lv Z-y, Yang J. Psychological impacts of the COVID-19 epidemic on Chinese people: Exposure, post-traumatic stress symptom, and emotion regulation. Asian Pacific Journal of Tropical Medicine. 2020; 13(6):252.
- Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. New England Journal of medicine. 2020.
- Del Borrello G, Giraudo I, Bondone C, Denina M, Garazzino S, Linari C, et al. SARS‐COV‐2–associated coagulopathy and thromboembolism prophylaxis in children: a single‐center observational study. Journal of Thrombosis and Haemostasis. 2021; 19(2):522-30.
- de Niet A, Waanders BL, Walraven I. The role of children in the transmission of mild SARS‐CoV‐2 infection. Acta Paediatrica (Oslo, Norway: 1992). 2020.
- Matthai J, Shanmugam N, Sobhan P. Coronavirus disease (COVID-19) and the gastrointestinal system in children. Indian pediatrics. 2020; 57(6):533-5.
- Fu L, Wang B, Yuan T, Chen X, Ao Y, Fitzpatrick T, et al. Clinical characteristics of coronavirus disease 2019 (COVID-19) in China: a systematic review and meta-analysis. Journal of Infection. 2020; 80(6):656-65.
- Zhou P, Yang X-L, Wang X-G, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020; 579(7798):270-3.
- Liu W, Zhang Q, Chen J, Xiang R, Song H, Shu S, et al. Detection of Covid-19 in children in early January 2020 in Wuhan, China. New England Journal of Medicine. 2020; 382(14):1370-1.
- Cavallo F, Rossi N, Chiarelli F. Novel coronavirus infection and children. Acta Bio Medica: Atenei Parmensis. 2020; 91(2):172.
- Giannis D, Ziogas IA, Gianni P. Coagulation disorders in coronavirus infected patients: COVID-19, SARS-CoV-1, MERS-CoV and lessons from the past. Journal of Clinical Virology. 2020; 127:104362.
- Loi M, Branchford B, Kim J, Self C, Nuss R. COVID‐19 anticoagulation recommendations in children. Pediatric blood & cancer. 2020.
- Eastin C, Eastin T. Clinical Characteristics of Coronavirus Disease 2019 in China: Guan W, Ni Z, Hu Y, et al. N Engl J Med. 2020 Feb 28 [Online ahead of print. The Journal of Emergency Medicine. 2020; 8(4):711.
- Wang Y, Zhang S, Wei Q, Zhao M, Mei H, Zhang Z, et al. COVID-19 complicated with DIC: 2 cases report and literature review. Chinese Journal of Hematology. 2020; 41(3):245-7.
- Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. Journal of thrombosis and haemostasis. 2020; 18(4):844-7.
- Lippi G, Plebani M, Henry BM. Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: a meta-analysis. Clinica chimica acta. 2020; 506:145-8.
- Goldenberg NA, Sochet A, Albisetti M, Biss T, Bonduel M, Jaffray J, et al. Consensus‐based clinical recommendations and research priorities for anticoagulant thromboprophylaxis in children hospitalized for COVID‐19–related illness. Journal of Thrombosis and Haemostasis. 2020; 18(11):3099-105.
- Ponti G, Maccaferri M, Ruini C, Tomasi A, Ozben T. Biomarkers associated with COVID-19 disease progression. Critical reviews in clinical laboratory sciences. 2020; 57(6):389-99.
- Noni M, Koukou D-M, Tritzali M, Kanaka-Gantenbein C, Michos A, Spoulou V. Coagulation Abnormalities and Management in Hospitalized Pediatric Patients With COVID-19. The Pediatric Infectious Disease Journal. 2022; 41(7):570.
- Yin S, Huang M, Li D, Tang N. Difference of coagulation features between severe pneumonia induced by SARS-CoV2 and non-SARS-CoV2. J Thromb Thrombolysis. 2021; 51(4):1107-10.
- Mitchell WB, Davila J, Keenan J, Jackson J, Tal A, Morrone KA, et al. Children and young adults hospitalized for severe COVID‐19 exhibit thrombotic coagulopathy. Pediatric Blood & Cancer. 2021; 68(7):e28975.
- Shi S, Qin M, Shen B, Cai Y, Liu T, Yang F, et al. Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA cardiology. 2020; 5(7):802-10.
- Boyarchuk O, Perestiuk V, Kosovska T and Volianska L (2024) Coagulation profile in hospitalized children with COVID-19: pediatric age dependency and its impact on long COVID development. Front. Immunol. 15:1363410.23. Yang Z, Shi J, He Z, Lü Y, Xu Q, Ye C, et al. Predictors for imaging progression on chest CT from coronavirus disease 2019 (COVID-19) patients. Aging (Albany NY). 2020; 12(7):6037.
- Aliasgarzade S, Matin S, Javaheri N, Aliasgarzade J, Aghamohammadi V. Coagulation Disorders in Hospitalized COVID-19 Patients and Relationship with Disease Outcome: A Cross-sectional Study. Arch Clin Infect Dis. 2021; 16(5): e114213
- Tang N, Bai H, Chen X, Gong J, Li D, Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. Journal of thrombosis and haemostasis. 2020; 18(5):1094-9.
- Ganji A, Farahani I, Khansarinejad B, Ghazavi A, Mosayebi G. Increased expression of CD8 marker on T-cells in COVID-19 patients. Blood Cells, Molecules, and Diseases. 2020; 83:102437.
- Yin S, Huang M, Li D, Tang N. Difference of coagulation features between severe pneumonia induced by SARS-CoV2 and non-SARS-CoV2. Journal of thrombosis and thrombolysis. 2021; 51(4):1107-10.
- Xu P, Zhou Q, Xu J. Mechanism of thrombocytopenia in COVID-19 patients. Annals of hematology. 2020; 99(6):1205-8.
- Qu R, Ling Y, Zhang Yhz, Wei Ly, Chen X, Li Xm, et al. Platelet‐to‐lymphocyte ratio is associated with prognosis in patients with coronavirus disease‐19. Journal of medical virology. 2020; 92(9):1533-41.
- Kander T. Coagulation disorder in COVID-19. The Lancet Haematology. 2020; 7(9):e630-e2.
- Helms J, Tacquard C, Severac F, Leonard-Lorant I, Ohana M, Delabranche X, et al. High risk of thrombosis in patients with severe SARS-CoV-2 infection: a multicenter prospective cohort study. Intensive care medicine. 2020; 46(6):1089-98.
- Zanza C, Racca F, Longhitano Y, Piccioni A, Franceschi F, Artico M, et al. Risk management and treatment of coagulation disorders related to COVID-19 infection. International Journal of Environmental Research and Public Health. 2021; 18(3):1268.
- Llitjos J, Leclerc M, Chochois C, Monsallier J, Ramakers M, Auvray M, et al. Alta incidencia de eventos tromboembólicos venosos en pacientes con COVID-19 grave anticoagulado. J Thromb Haemost. 2020.
- Cattaneo M, Bertinato EM, Birocchi S, Brizio C, Malavolta D, Manzoni M, et al. Pulmonary embolism or pulmonary thrombosis in COVID-19? Is the recommendation to use high-dose heparin for thromboprophylaxis justified? Thrombosis and haemostasis. 2020; 120(08):1230-2.
- Levi M, Thachil J, Iba T, Levy JH. Coagulation abnormalities and thrombosis in patients with COVID-19. The Lancet Haematology. 2020; 7(6):e438-e40.
- Lippi G, Bonfanti L, Saccenti C, Cervellin G. Causes of elevated D-dimer in patients admitted to a large urban emergency department. European journal of internal medicine. 2014; 25(1):45-8.
)