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The following is a summary of “Trends in the Diagnosis of Pediatric Venous Thromboembolism and Arterial Ischemic Stroke during the COVID-19 Pandemic: An Administrative Database Study,” published in the September 2024 issue of Pediatrics by Kumar et al.
Venous thromboembolism (VTE) and arterial ischemic stroke (AIS) in hospitalized children have been areas of concern, particularly during the COVID-19 pandemic, which may have influenced these conditions.
Researchers conducted a retrospective study to explore trends in pediatric VTE and AIS diagnoses during the COVID-19 pandemic, along with the use of pharmacological thromboprophylaxis.
They used the Pediatric Health Information Systems (PHIS) database to examine children admitted between January 2018 and December 2021. International Classification of Diseases (ICD-10) codes identified VTE, AIS, and COVID-19, while pharmacy billing codes were analyzed for pharmacological thromboprophylaxis use.
The results showed that 1,759,701 unique patients underwent 2,234,135 inpatient admissions. The rate of VTE increased from 84 cases per 10,000 admissions in 2018-2019 to 108 cases per 10,000 admissions in 2020-2021, reflecting a 28.6% increase (P<0.001).
In contrast, the rate of AIS remained stable during the study period. Compared to 2018-2019, children diagnosed with VTE in 2020-2021 had longer hospitalizations and were more likely to be admitted to the intensive care unit. In 2020-2021, a COVID-19 diagnosis was linked to a 1.35-fold (95% CI: 1.24-1.45) increase in VTE odds but not in AIS. The use of pharmacologic thromboprophylaxis increased from 1.5% of hospitalizations in 2018-2019 to 3.0% in 2020-2021 (P <0.001). During 2020-2021, a COVID-19 diagnosis was associated with an 11-fold (95% CI: 10.86-11.49; P <0.001) increase in pharmacological thromboprophylaxis use.
The study concluded that pediatric VTE rates rose during the pandemic, and a COVID-19 diagnosis modestly increased the odds of VTE despite higher use of pharmacological thromboprophylaxis.
Source: jpeds.com/article/S0022-3476(24)00431-1/abstract
