https://onlinelibrary.wiley.com/doi/epdf/10.1111/jth.14768

Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia.

Hematologic abnormalities are common in children admitted to pediatric intensive care units (PICUs) Some are primary and related to the underlying hematologic disease in the child such as severe anem

/pdf/hematological-problems-in-pediatric-intensive-care-41npmyo6ot.pdf

Hematological Problems in Pediatric Intensive Care

Little evidence of increased thrombotic risk is available in COVID-19 patients. Our purpose was to assess thrombotic risk in severe forms of SARS-CoV-2 infection. All patients referred to 4 intensive care units (ICUs) from two centers of a French tertiary hospital for acute respiratory distress syndrome (ARDS) due to COVID-19 between March 3rd and 31st 2020 were included. Medical history, symptoms, biological data and imaging were prospectively collected. Propensity score matching was performed to analyze the occurrence of thromboembolic events between non-COVID-19 ARDS and COVID-19 ARDS patients. 150 COVID-19 patients were included (122 men, median age 63 [53; 71] years, SAPSII 49 [37; 64] points). Sixty-four clinically relevant thrombotic complications were diagnosed in 150 patients, mainly pulmonary embolisms (16.7%). 28/29 patients (96.6%) receiving continuous renal replacement therapy experienced circuit clotting. Three thrombotic occlusions (in 2 patients) of centrifugal pump occurred in 12 patients (8%) supported by ECMO. Most patients (> 95%) had elevated D-dimer and fibrinogen. No patient developed disseminated intravascular coagulation. Von Willebrand (vWF) activity, vWF antigen and FVIII were considerably increased, and 50/57 tested patients (87.7%) had positive lupus anticoagulant. Comparison with non-COVID-19 ARDS patients (n = 145) confirmed that COVID-19 ARDS patients (n = 77) developed significantly more thrombotic complications, mainly pulmonary embolisms (11.7 vs. 2.1%, p < 0.008). Coagulation parameters significantly differed between the two groups. Despite anticoagulation, a high number of patients with ARDS secondary to COVID-19 developed life-threatening thrombotic complications. Higher anticoagulation targets than in usual critically ill patients should therefore probably be suggested.

/pdf/high-risk-of-thrombosis-in-patients-with-severe-sars-cov-2-33bb5czu95.pdf

High risk of thrombosis in patients with severe SARS-CoV-2 infection: a multicenter prospective cohort study.

COVID-19 and its implications for thrombosis and anticoagulation.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/jth.14810

ISTH interim guidance on recognition and management of coagulopathy in COVID-19.

Already in the 19th century some of the first clinical and pathological observations related to DIC were made. A more precise description of DIC and its underlying pathogenesis had to wait until the 20th century, when more insight in the mechanism of blood coagulation was attained and better laboratory tests had become available. Although the general picture of DIC is known to most clinicians, a precise description of the syndrome, a good working definition and a useful scoring system are not available. The SSC subcommittee on DIC has worked over the last years to come closer to achieve these goals. Traditionally DIC is diagnosed in association with the following

Towards Definition, Clinical and Laboratory Criteria, and a Scoring System for Disseminated Intravascular Coagulation* On behalf of the Scientific Subcommittee on Disseminated Intravascular Coagulation (DIC) of the ISTH

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Towards Definition, Clinical and Laboratory Criteria, and a Scoring System for Disseminated Intravascular Coagulation* On behalf of the Scientific Subcommittee on Disseminated Intravascular Coagulation (DIC) of the ISTH