Clinical and hemostatic features in children with varying severity of COVID-19 in Irkutsk

Introduction. As pediatric COVID-19 is often asymptomatic or mild, investigating hemostatic and clinical features in these cases is vital for assessing complication risks, especially since existing research prioritizes severe manifestations.

The aim. Analysis of clinical and hemostatic features in children with varying severity of COVID-19 in Irkutsk.

Materials and methods. This retrospective study analyzed 164 medical records of children hospitalized with COVID-19 at the Ivano-Matreninskaya City Children's Clinical Hospital and the Irkutsk Regional Infectious Diseases Hospital between March 2021 and February 2022. The participants were divided into two groups: the first group included 85 children with mild disease severity, and the second group comprised 79 children with moderate severity. Severe course was observed in 3 patients who were transferred to the Irkutsk Regional Infectious Diseases Hospital. We assessed clinical features and basic coagulogram parameters (5 clotting tests and D-dimer). Statistical analysis was performed using Microsoft Office 2019 and Statistica Basic Academic 13.

Results. Among children with COVID-19, children aged 5–15 years were predominant, with no gender differences between the groups. The disease was predominantly mild to moderate in severity. Moderate disease severity was associated with a significant increase in fibrinogen and D-dimer levels, which correlated with the duration of fever and the presence of thoracalgia syndrome. A shortening of APTT in children with a moderate disease course correlated with the presence of shortness of breath.

Conclusions. Despite the predominantly mild-to-moderate course of COVID-19 in children, monitoring coagulogram parameters is essential. A significant number of children with moderate severity show elevated D-dimer and fibrinogen levels, as well as shortened APTT, indicating a risk of hemostatic complications and correlating with more severe clinical symptoms. Further research is needed to understand how COVID-19 severity aff ts hemostasis and to prevent serious complications.

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