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Arterial Thrombus in a Neonate with Covid-19 Positive Mother


Affiliations
1 Senior Consultant, Pediatrician and Neonatologist- NH SRCC Children’s Hospital, Mumbai and Breach Candy Hospital, Mumbai, India
2 Junior Consultant, Critical Care, NH SRCC Children’s Hospital, Mumbai, India
     

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Thrombotic disease in newborns is uncommon; its incidence is reported as 3-5 per 1, 00,000 live births. Most of them are venous thromboembolisms accounting for 2/3rd of reported cases and arterial thrombosis is 1/3rd of the lot. Newborns are at a higher risk for bleeding as well as thrombotic tendency due to immature and low levels of procoagulant and anticoagulant proteins in a predisposed setting. We present a case with vertical transmission of SARS-COV2 infection and the coagulopathy therewith presenting as arterial thrombus at birth which was, effectively treated with anticoagulation therapy.

Keywords

neonate, COVID-19, thrombus, Doppler, anticoagulation.
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  • Vivanti AJ, Vauloup-Fellous C, Prevot S, Zupan V, Suffee C, Do Cao J, Benachi A, De Luca D. Transplacental transmission of SARS-CoV-2 infection. Nat Commun. 2020;11(1):3572. DOI: 10.1038/s41467-020-17436-6. PMID: 32665677; PMCID: PMC7360599.

  • Andrew ME, Monagle P, deVeber G, Chan AK. Thromboembolic disease and antithrombotic therapy in newborns. Hematology Am Soc Hematol Educ Program. 2001:358-74. DOI: 10.1182/asheducation-2001.1.358. PMID: 11722993.

  • Shanes ED, Mithal LB, Otero S, Azad HA, Miller ES, Goldstein JA. Placental Pathology in COVID-19. Am J Clin Pathol. 2020;154(1):23-32. DOI: 10.1093/ajcp/aqaa089. PMID: 32441303; PMCID: PMC7279066.

  • Schmidt B, Andrew M. Neonatal thrombosis: report of a prospective Canadian and international registry. Pediatrics. 1995;96(5 Pt 1):939-43. PMID: 7478839.

  • Nowak-Göttl U, von Kries R, Göbel U. Neonatal symptomatic thromboembolism in Germany: two year survey. Arch Dis Child Fetal Neonatal Ed. 1997;76(3):F163-7. DOI: 10.1136/ fn.76.3.f163. PMID: 9175945; PMCID: PMC1720641.

  • Rizzi M, Goldenberg N, Bonduel M, Revel-Vilk S, Amankwah E, Albisetti M. Catheter-Related Arterial Thrombosis in Neonates and Children: A Systematic Review. Thromb Haemost. 2018;118(6):1058-66. DOI: 10.1055/s-0038-1642635. Epub 2018 Apr 25. PMID: 29695022.

  • Venkateswaran L, Scaglia F, McLin V, Hertel P, Shchelochkov OA, Karpen S, Mahoney D Jr, Yee DL. Ornithine transcarbamylase deficiency: a possible risk factor for thrombosis. Pediatr Blood Cancer. 2009;53(1):100-2. DOI: 10.1002/ pbc.22016. PMID: 19343772; PMCID: PMC4869977.

  • Amankwah EK, Atchison CM, Arlikar S, Ayala I, Barrett L, Branchford BR, Streiff M, Takemoto C, Goldenberg NA. Risk factors for hospital-sssociated venous thromboembolism in the neonatal intensive care unit. Thromb Res. 2014;134(2):305- 9. DOI: 10.1016/j.thromres.2014.05.036. Epub 2014 Jun 2. PMID: 24953982; PMCID: PMC7269108.

  • Sharps MC, Hayes DJL, Lee S, Zou Z, Brady CA, Almoghrabi Y, Kerby A, Tamber KK, Jones CJ, Adams Waldorf KM, Heazell AEP. A structured review of placental morphology and histopathological lesions associated with SARS-CoV-2 infection. Placenta. 2020;101:13-29. DOI: 10.1016/j.placenta. 2020.08.018. Epub 2020 Aug 23. PMID: 32911234; PMCID: PMC7443324.

  • Monagle P, Chan AKC, Goldenberg NA, Ichord RN, Journeycake JM, Nowak-Göttl U, Vesely SK. Antithrombotic therapy in neonates and children: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e737S-e801S. DOI: 10.1378/chest.11-2308. PMID: 22315277; PMCID: PMC3278066.

  • Malowany JI, Monagle P, Knoppert DC, Lee DS, Wu J, McCusker P, Massicotte MP, Williams S, Chan AK; Canadian Paediatric Thrombosis and Hemostasis Network. Enoxaparin for neonatal thrombosis: a call for a higher dose for neonates. Thromb Res. 2008;122(6):826-3. DOI: 010.1016/j. thromres.2007.11.009. Epub 2008 Jan 18. PMID: 18207492.

  • Villar J, Ariff S, Gunier RB, et al. Maternal and Neonatal Morbidity and Mortality Among Pregnant Women With and Without COVID-19 Infection: The INTERCOVID Multinational Cohort Study. JAMA Pediatr. 2021;175(8):817- 26. DOI: 10.1001/jamapediatrics.2021.1050. Erratum in: JAMA Pediatr. 2022 Jan 1;176(1):104. PMID: 33885740; PMCID: PMC8063132.

  • de Roquetaillade C, Chousterman BG, Tomasoni D, Zeitouni M, Houdart E, Guedon A, Reiner P, Bordier R, Gayat E, Montalescot G, Metra M, Mebazaa A. Unusual arterial thrombotic events in Covid-19 patients. Int J Cardiol. 2021;323:281-84. DOI: 10.1016/j.ijcard.2020.08.103. Epub 2020 Sep 10. PMID: 32918938; PMCID: PMC7481127.


Abstract Views: 195

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  • Arterial Thrombus in a Neonate with Covid-19 Positive Mother

Abstract Views: 195  |  PDF Views: 1

Authors

Dr. Vinit Samdani
Senior Consultant, Pediatrician and Neonatologist- NH SRCC Children’s Hospital, Mumbai and Breach Candy Hospital, Mumbai, India
Dr. Abhilasha Punde Save
Junior Consultant, Critical Care, NH SRCC Children’s Hospital, Mumbai, India

Abstract


Thrombotic disease in newborns is uncommon; its incidence is reported as 3-5 per 1, 00,000 live births. Most of them are venous thromboembolisms accounting for 2/3rd of reported cases and arterial thrombosis is 1/3rd of the lot. Newborns are at a higher risk for bleeding as well as thrombotic tendency due to immature and low levels of procoagulant and anticoagulant proteins in a predisposed setting. We present a case with vertical transmission of SARS-COV2 infection and the coagulopathy therewith presenting as arterial thrombus at birth which was, effectively treated with anticoagulation therapy.

Keywords


neonate, COVID-19, thrombus, Doppler, anticoagulation.

References