Changes in Hematological, Clinical and Laboratory Parameters for Children with COVID-19: Single-Center Experience

Figures & data

Table 1 Hospital-Based Clinical Staging System for COVID-19 to Assess Disease Severity

Stage	Clinical Presentation	Characteristic Features
Stage A	Asymptomatic	Patients with no signs or symptoms of infection
Stage B	Mild Infection	Upper respiratory tract infection symptoms and other mild symptoms (including fever and gastrointestinal symptoms) without evidence of pneumonia
Stage C	Moderate Infection	Patients with hypoxia with oxygen saturation less than 93% at rest or presence of pneumonia not requiring ICU admission
Stage D	Severe Infection	Pneumonia requiring ICU admission or any of the following: 1. Respiratory rate of 30 breaths/min 2. Arterial oxygen partial pressure to fractional inspiratory oxygen ratio (PaO2/FiO2) less than 300 3. More than 50% lung involvement on imaging within 24–48 hours 4. Critical respiratory failure requiring mechanical ventilation, septic shock, or multi-organ dysfunction

Table 2 Demographics and Clinical Parameters of COVID-19-Infected Patients

Parameters	All Cases (n=43)	No ICU Visit (n=38)	With ICU Visit (n=5)	P–value
Demographic and clinical
Age (years)	5.8 (0.04–13.3)	5.9 (0.06–13.32)	1.4 (0.04–7.12)	0.04
Gender (female/male)	24/19	20/18 (52.6%)	4/1 (80.0%)	0.363
BMI	15.7±2.9	15.8±2.9	15.0±2.8	0.58
Comorbidities (positive/negative)	26/17 (60.5%)	22/16 (57.9%)	4/1 (80.0%)	0.633
Hypertension	2/41 (4.7%)	0/38 (0%)	2/3 (40.0%)	0.011
Diabetes	1/42 (2.3%)	1/37 (2.6%)	0/5 (0%)	1.000
Bleeding	0/43 (0%)	0/38 (0%)	0/5 (0%)	–
Previous VTE	0/43 (0%)	0/38 (0%)	0/5 (0%)	–
Malignancy	9/34 (20.9%)	8/30 (21.1%)	1/4 (20.0%)	1.000
Hyperlipidemia	1/42 (2.3%)	1/37 (2.6%)	0/5 (0%)	1.000
Stem Cell Transplantation	6/37 (14.0%)	4/34 (10.5%)	2/3 (40%)	0.135
Symptoms (positive/negative)	27/16 (62.8%)	23/15 (60.5%)	4/1 (80.0%)	0.635
Fever	23/20 (53.5%)	19/19 (50.0%)	4/1 (80.0%)	0.351
Respiratory	5/38 (11.6%)	2/36 (5.3%)	3/2 (60.0%)	0.008
GIT related	3/40 (7.0%)	3/35 (7.9%)	0/5 (0%)	1.000
COVID-19 Stage				0.072
Stage A	14 (32.6%)	14 (36.8%)	0 (0%)
Stage B	27 (62.8%)	23 (60.5%)	4 (80%)
Stage C	1 (2.3%)	0 (0%)	1 (20%)
Stage D	1 (2.3%)	1 (2.6%)	0 (0%)
Stage E	0 (0%)	0 (0%)	0 (0%)
ABO groups (n=41)				0.049
A	13 (31.7%)	9 (25.0%)	4 (80.0%)
AB	2 (4.9%)	2 (5.6%)	0 (0%)
B	8 (19.5%)	7 (19.4%)	1 (20.0%)
O	18 (43.9%)	18 (50.0%)	0 (0%)

Notes: The variable BMI was normally distributed while age followed a non-normal distribution. Data are presented as mean±standard deviation for normally distributed and median (minimum-maximum) for non-normally distributed variable.

Abbreviations: GIT, gastrointestinal tract; DIC, disseminated intravascular coagulopathy; INR, international normalized ratio; PT, prothrombin time; HCT, hematopoietic cell transplant.

Figure 1 Sequential D-dimer values.

Table 3 Length of Stay by Coagulation Biomarkers at Admission

At Presentation	Hospital Stay				P-value
	< 3 Days	3–7 Days	7–14 Days	14 and Above
Protein C					0.802
Low	0 (0%)	1 (14.3%)	1 (4.5%)	0 (0%)
Normal	3 (100%)	6 (85.7%)	20 (90.9%)	5 (100%)
Protein S					1.000
Low	-	-	-	-
Normal	3 (100%)	7 (100%)	21 (95.5%)	5 (100%))
vW Ag					0.388
Low	-	-	-	-
Normal	3 (100%)	4 (57.1%)	15 (68.2%)	2 (40%)
High	0 (0%)	3 (42.9%)	7 (31.8%)	3 (60%)
FVIII					0.036
Low	-	-	-	-
Normal	3 (100%)	6 (85.7%)	18 (81.8%)	1 (20%)
High	0 (0%)	1 (14.3%)	4 (18.2%)	4 (80.0%)
Fibrinogen					0.151
Low (n=5)	0 (0%)	0 (0%)	5 (23.8%)	0 (0%)
Normal (n=25)	3 (100%)	7 (100%)	12 (57.1%)	3 (50%)
High (n=7)	0 (0%)	0 (0%)	4 (19.0%)	3 (50%)