ÇOCUKLUK ÇAĞI COVID-19 HASTALIĞINDA HEMATOLOJİK BULGULAR VE ANTİKOAGÜLAN KULLANIMI

Abstract

Ağır akut respiratuvar sendrom koronavirüs-2 (SARS-CoV-2) ajanının yol açtığı Koronavirüs-2019 hastalığı (COVID-2019), bir solunum yolu hastalığı olarak düşünülmekle birlikte, birçok sistemde etkilenmeye yol açabilir. Bu olgularda hematolojik komplikasyonlar izlenebilir. Erişkin COVID-19 hastalarında lenfopeni ve hiperkoagülabilite bildirilmiştir ve bunların varlığı kötü prognoz ile ilişkilendirilmiştir. Pediatrik COVID-19 olgularında izlenen hematolojik bulguların erişkinlerden farklı özellikler gösterebildiği kaydedilmiştir. Gözlemsel çalışmalar, COVID-19 ilişkili hastalık nedeniyle hastaneye yatırılan çocuklarda, erişkinlerdeki gibi, venöz tromboembolizm riskinin arttığına işaret etmektedir. Ancak, etkilenen olgularda antikoagülan tromboprofilaksi önerilerini içeren rehberler ağırlıklı olarak erişkin hastalar için oluşturulmuştur. Bu derlemede SARS-CoV-2 enfeksiyonu olan çocukların hematolojik bulgularının gözden geçirilmesi ve etkilenen çocuklarda kanıta dayalı antikoagülan tromboprofilaksi önerilerinin sunulması amaçlanmıştır.

Keywords

• Çocuklar
• SARS-CoV-2
• COVID-19
• Hematolojik bulgular
• Venöz tromboembolizm
• Tromboprofilaksi

HEMATOLOGICAL MANIFESTATIONS AND ANTICOAGULANT USE IN CHILDREN WITH COVID-19 DISEASE

Abstract

Coronavirus disease 2019 (COVID-2019) caused by severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2), though mainly affecting the respiratory system, may cause manifestations in multiple organ systems, e.g. hematological complications may be observed in affected individuals. Lymphopenia and hypercoagulability have been reported in adult COVID-19 patients, and have been associated with a poor prognosis. Hematological findings observed in pediatric COVID-19 cases have been reported to differ from those seen in adults. Observational studies in children with a COVID-19-related illness have pointed, like in adults, to an increased risk for venous thromboembolism. However, guidelines including recommendations for anticoagulant thromboprophylaxis in COVID-19 patients have mainly been developed for adult population. This review summarizes the hematological manifestations of children with SARS-CoV-2 infection, and presents evidence-based recommendations for anticoagulant thromboprophylaxis in affected children.

Keywords

• Children
• SARS-CoV-2
• Hematological manifestations
• Venous thromboembolism
• Thromboprophylaxis

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