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Revista Cubana de Pediatría
versión On-line ISSN 1561-3119
Resumen
ACOSTA TORRES, José Ramón; PEREZ CUTINO, Maite; RIVERA KEELING, Carlos y RODRIGUEZ PRIETO, Magela. Vascular thrombosis in pediatric patients affected by COVID-19. Rev Cubana Pediatr [online]. 2022, vol.94, suppl.1 Epub 15-Dic-2022. ISSN 1561-3119.
Introduction:
The disease by the new coronavirus caused a pandemic with an impact on children's health, which made clear the relationship between a state of inflammation, hypercoagulability and vascular thrombosis as the genesis of acute respiratory failure.
Objective:
To describe the epidemiology of vascular thrombosis in pediatrics and to summarize the main available evidence related to the interaction between hyperinflammation, immune dysregulation, hypercoagulability and thrombosis.
Methods:
Between December 2019 and June 2021, an orderly review of the medical databases PubMed and Google Scholar was carried out, in which the terms of the titles (MeSH) were used: "SARS-CoV-2 and Covid-19"; "coronavirus" and "infection"; "sepsis" and "Covid-19" and "Multisystem inflammatory syndrome in children" and "MIS-C and "PIMS-TS".
Analysis and synthesis of information:
Vascular thrombosis in pediatrics occurs between 1.2 and 26%, generated by inflammatory processes that lead to endothelitis with alterations of microvascular structures and thrombus formation. There are risk factors such as age≥ 12 years, mechanical ventilation, deep venous approach, presence of multisystem inflammatory syndrome, obesity and cancer. The diagnosis is supported by specific analyzes, especially the D-dimer, ultrasound with Dopplers and tomography. Anticoagulant treatment has not been unified and will depend on the protocols indicated in each country.
Conclusions:
Vascular thrombosis in pediatrics, although infrequent, should be kept in mind to detect its presence in severe patients with risk factors and act accordingly with established protocols.
Palabras clave : COVID-19; vascular thrombosis; SIM-P; D-dimer; cytokines.