PB0060 - Thrombosis in Greek Children before and after SARS-CoV-2 Outbreak: a Single Centre Experience

Sunday, June 25, 2023

18:30 – 19:30 ET

Room: Exhibition

Presenting Author(s)

ATHINA DETTORAKI, MD, MSc, PhD (she/her/hers)

PAEDIATRICIAN
Haemophilia Centre/Haemostasis and Thrombosis Unit, “Aghia Sophia” Children’s Hospital, Athens, Greece
ATHENS, Attiki, Greece

Co-Author(s)

LOUKIA IOANNIDOU, MD, MPH

PAEDIATRICIAN
Haemophilia Centre/Haemostasis and Thrombosis Unit, “Aghia Sophia” Children’s Hospital, Athens, Greece
ATHENS, Attiki, Greece
AM

AIKATERINI MICHALOPOULOU

PAEDIATRICIAN
Haemophilia Centre/Haemostasis and Thrombosis Unit, “Aghia Sophia” Children’s Hospital, Athens, Greece
ATHENS, Attiki, Greece
NP

NEFELI PAPAGEORGIOU

PAEDIATRICIAN
Haemophilia Centre/Haemostasis and Thrombosis Unit, “Aghia Sophia” Children’s Hospital, Athens, Greece
ATHENS, Attiki, Greece
SS

STEFANOS SASLIS

BIOLOGIST
Haemophilia Centre/Haemostasis and Thrombosis Unit, “Aghia Sophia” Children’s Hospital, Athens, Greece
ATHENS, Attiki, Greece
IS

IOANNA STAMATI

NURSE
Haemophilia Centre/Haemostasis and Thrombosis Unit, “Aghia Sophia” Children’s Hospital, Athens, Greece
ATHENS, Attiki, Greece
HK

HELEN KARELIOTI

BIOLOGIST
Haemophilia Centre/Haemostasis and Thrombosis Unit, “Aghia Sophia” Children’s Hospital, Athens, Greece
ATHENS, Attiki, Greece
ZK

ZOEY KAPSIMALI

BIOCHEMIST
Haemophilia Centre/Haemostasis and Thrombosis Unit, “Aghia Sophia” Children’s Hospital, Athens, Greece
ATHENS, Attiki, Greece
CK

CHRISTINA KANAKA-GANTENBEIN

PROFESSOR OF PEDIATRICS- PEDIATRIC ENDOCRINOLOGY
Division of Endocrinology, Diabetes and Metabolism, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, “Aghia Sophia” Children’s Hospital, Athens, Greece
ATHENS, Attiki, Greece
HP

Helen Pergantou

PAEDIATRICIAN, DIRECTOR OF HAEMOPHILIA CENTRE/HEAMOSTASIS AND THROMBOSIS UNIT
Haemophilia Centre/Haemostasis and Thrombosis Unit, “Aghia Sophia” Children’s Hospital, Athens, Greece
Athens, Argolis, Greece

Background: Characteristics of paediatric thrombosis during the COVID-19 pandemic are not well defined.

Aims: To identify the characteristics of paediatric thrombosis amid pandemic and compare it with pre-pandemic data.

Methods: Data were retrospectively collected for children with thrombosis, referred to a paediatric thrombosis referral centre. Patients were categorized in two study periods: 01/01/2017-31/12/2019 (P1) and 01/01/2020-31/12/2022 (P2). Superficial vein thrombosis, neonate and oncologic patients were excluded. The categorical variables were described by frequency distributions and compared with x2-test.

Results: On total, 145 patients (59% males, mean age 6.9±10.8 years) were documented in P1 and 162 patients (58% males, 7.3±10.8 years) in P2 period. Most frequent site in both periods included central nervous system (CNS-53.1% vs 44.7%, P1 vs P2, not significant, NS), followed by deep vein thrombosis (DVT-31.5% vs 38%, P1 vs P2, NS). Interestingly, there was a statistically significant (χ2=25.565 p=0.001) i) decrease in arterial ischeamic stroke (AIS) (34.7% vs 23.9%), ii) increase in cerebral venous sinus thrombosis (CSVT) (8.5% vs 18.7%) and 3) increase in lower extremity DVT (23.7% vs 35.1%). Infection was the main cause of thrombosis in both periods (19.4% and 27.5%) (p=0.816). SARS-CoV-2-associated thrombosis was documented in twelve children (7%) in P2 (4 CSVT-2%, 2AIS-1%, 5 VTE-3%, 4 Pulmonary Embolism-2% and 1Arterial Thrombosis -0.6%). Distribution of prothrombotic risk factors remained the same. Heterozygosity for FVLeiden and FII20210A mutations were found in 8.9% and 5.5% of patients in P1 and 5.7% and 2.3% in P2 (NS) and homozygosity for MTHFR-C776T in 43.9% in P1 and 42.2% in P2 (NS).

Conclusion(s): A mild increase in the rate of thrombosis in children during pandemic was found in a reference paediatric centre for thrombosis. Rates of AIS were significantly reduced and CSVT significantly increased during the pandemic, whereas SARS-CoV-2-associated thrombosis was documented in only 7% of children.