key: cord-0935486-fg8pclua
authors: Loi, Michele; Branchford, Brian; Kim, John; Self, Chelsea; Nuss, Rachelle
title: COVID‐19 anticoagulation recommendations in children
date: 2020-06-18
journal: Pediatr Blood Cancer
DOI: 10.1002/pbc.28485
sha: dea026fb705a17d5d3d570b343286f45b9f91f9e
doc_id: 935486
cord_uid: fg8pclua

nan

The American Society of Pediatric Hematology/Oncology

To the Editor: a platelet count that is only mildly decreased, a partial thromboplastin time that is normal-to-mildly prolonged, and no signs of microangiopathy. Typical DIC can also be seen in adults and graded per the ISTH scoring system. 7, 8 The presence and severity of DIC in adults is suggested to have strong prognostic value. 9 Rising D-dimer over time, reflecting increasing coagulation and fibrinolysis, is also associated with a worse mortality in adults. 10 We recommend trending the DIC score 7 • Systemic alteplase may be preferred over local mechanical thrombolysis given the risk of exposure with transfer and utilization of an interventional suite; however, contraindications to systemic alteplase must also be considered current knowledge in adults and appreciation of the risk for thrombosis in children, we have developed preliminary recommendations for laboratory and imaging evaluation, assessment of thrombotic risk, and anticoagulation therapy. We recognize that as the pediatric experience with COVID-19 increases, additional information will be garnered and the recommendations will likely need modification. We present our local institutional recommendations, and further consideration of consensus recommendation by hematology societies at-large is welcomed and anticipated.

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