Coagulopathy in children with covid-19: features of the acute period of the disease and long-term consequences

Objective. To assess the orientation of changes in the coagulation system in children in the acute and long-term periods after COVID-19 infection. Materials and methods. The results of the examination of children aged from 1 to 18 with confirmed COVID-19 infection were included in a cohort retrospective study conducted in order to assess the orientation of changes in the coagulation system in children in the acute and long-term period after COVID-19 infection. The set of examinations included indicators for assessing vascular-platelet (platelet count, platelet aggregation) and plasma-coagulation (INR, APTT, thrombin time, fibrinogen level, antithrombin III, SFMC, euglobulin lysis, D-dimer level) links of hemostasis. 130 children comprising the main observation group and 113 children of the control group (healthy children) were examined. Results. It was determined that the acute period of a new coronavirus infection in children is characterized by changes in the hemostasis system, and disturbances affect all links - vascular platelet, plasma coagulation and fibrinolysis system, not depending on the severity of the infection. The changes persist within 4–4.5 months after the infection. Conclusion. Younger children (1–5 years old) are the most alert. Both in the debut of COVID-19 and in the postcovid period, the maximum number of abnormalities was revealed in these patients and the largest number of children had these changes. The most favorable state of the blood coagulation system is determined in the older age group (children 11–18 years old). Despite the fact that the onset of the disease in children is accompanied by significant changes in hemostasis indicators, which is typical for COVID-19, in the post-ovarian period, almost all indicators reached their optimal values. The data obtained confirm the opinion that one of the complications of COVID-19 is the development of coagulopathy, which in turn can lead to thrombosis in large and small vessels, and inhibition of fibrinolysis (hypofibrinolysis) can be a predictor of thromboembolic complications. Children who have suffered a new coronavirus infection form a risk group for the development of the above-mentioned complications and require more attention, possibly follow-up for a long period after the disease.