ArticleJournal of thrombosis and haemostasis : JTH2021
Multisystem inflammatory syndrome in children (MIS-C) and the prothrombotic state: Coagulation profiles and rotational thromboelastometry in a MIS-C cohort.
Article in Journal of thrombosis and haemostasis : JTH, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed, 40 citations in OpenAlex.
- Multisystem Inflammatory Syndrome in Children with tailored therapy and six-month outcome.Pediatric research · 2026Article
- MIS-C: Diagnosis, Management, and Outcomes.Open forum infectious diseases · 2026Review
- Policy Adherence to Antithrombotic Therapy for Prophylactic Anticoagulation in Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19.Journal of pediatrics. Clinical practice · 2025Article
- Clinical Characteristics and Outcomes in Multisystemic Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19: A 12-Month Prospective Study.Microorganisms · 2025Article
- A Clinical Case of Multisystem Inflammatory Syndrome After SARS-CoV-2 Infection Associated with Group A β-Hemolytic Streptococcus Coinfection and Venous Thrombosis in a Child with Congenital Thrombophilia.Current issues in molecular biology · 2025Article
- Molecular Mechanisms and Pathophysiology of Myocardial Disease: Insights from Pediatric Inflammatory Multisystem Syndrome (PIMS) Associated with SARS-CoV-2.International journal of molecular sciences · 2025Article
- The changes of coagulation profiles in Kawasaki disease and its associations with clinical classification, intravenous immunoglobulin responsiveness and coronary artery involvement.Clinical and experimental medicine · 2024Article
- Severity predictors for multisystemic inflammatory syndrome in children after SARS-CoV-2 infection in Vietnam.Scientific reports · 2024Article
- New insight into the intravenous immunoglobulin treatment in Multisystem Inflammatory Syndrome in children and adults.Italian journal of pediatrics · 2024Review
- Aortoiliac arterial thrombosis and renal artery stenosis in a patient with neonatal multisystem inflammatory syndrome: a case report and review of literature.Frontiers in pediatrics · 2024Article
- COVID-19 and Thromboembolic Events in the Pandemic and Pre-Pandemic Era: A Pediatric Cohort.Viruses · 2023Article
- Thromboprophylaxis for Coagulopathy Related to COVID-19 in Pediatrics: A Narrative Review.Paediatric drugs · 2023Review
- Thrombotic Events in MIS-C Patients: A Single Case Report and Literature Review.Children (Basel, Switzerland) · 2023Article
- SHock-INduced Endotheliopathy (SHINE): A mechanistic justification for viscoelastography-guided resuscitation of traumatic and non-traumatic shock.Frontiers in physiology · 2023Review
- Thrombosis and hemorrhage experienced by hospitalized children with SARS-CoV-2 infection or MIS-C: Results of the PICNIC registry.Pediatric blood & cancer · 2022Article
- Lung Ultrasound Patterns in Multisystem Inflammatory Syndrome in Children (MIS-C)-Characteristics and Prognostic Value.Children (Basel, Switzerland) · 2022Article
- Clinical practice guidelines in multisystem inflammatory syndrome (MIS-C) related to COVID-19: a critical review and recommendations.World journal of pediatrics : WJP · 2022Review
- Intracardiac Thrombosis in the Three-Year-Old Boy with Normal Left Ventricle Systolic Function in MIS-C Associated with COVID-19.Mediterranean journal of hematology and infectious diseases · 2022Article
- Who Would Have Predicted Multisystem Inflammatory Syndrome in Children?Current rheumatology reports · 2022Review
- Multisystem inflammatory syndrome in children and Kawasaki disease: a critical comparison.Nature reviews. Rheumatology · 2021Review
Corrections and comments
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Authors and funding
17 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAdults infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have had high rates of thrombosis. A novel condition in children infected with SARS-CoV-2, multisystem inflammatory syndrome in children (MIS-C), has limited data on their prothrombotic state or need for thromboprophylaxis.
objectivesWe aimed to analyze the prothrombotic state using coagulation profiles, rotational thromboelastometry (ROTEM) parameters and clinical outcomes, to determine if this could aid in risk stratification for thromboprophylaxis.
methodsThis analysis included patients (<21 years of age) with a diagnosis of MIS-C (n = 40) and controls (presenting with suspicion of MIS-C but later ruled out; n = 26).
resultsMIS-C patients had higher levels of inflammatory markers including D-dimer (p < .0001), compared with controls, along with evidence of hypercoagulability on ROTEM with elevated evaluation of fibrinogen activity (FIBTEM) maximum clot firmness (MCF) (p < .05). For MIS-C patients with D-dimers >1000 ng/ml, there was a significant correlation of FIBTEM MCF (p < .0001) with a mean value of 37.4 (standard deviation 5.1). D-dimer >2144 ng/ml was predictive of intensive care unit admission (area under the curve [AUC] 0.80; 95% confidence interval, 0.60-0.99; p < .01; sensitivity: 82%, specificity: 75%), and elevated FIBTEM MCF (AUC 1 for >2500 ng/ml). MIS-C patients (50%) received enoxaparin thromboprophylaxis (in addition to aspirin) with significant improvement in their inflammatory and ROTEM parameters upon outpatient follow-up; none developed symptomatic thrombosis.
conclusionsDespite an observed prothrombotic state, none of the MIS-C patients (on aspirin alone or in combination with enoxaparin) developed symptomatic thrombosis. ROTEM, in addition to coagulation profiles, may be helpful to tailor thromboprophylaxis in critically ill MIS-C patients.
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