D-Dimer Elevation at Time of Admission is Associated with Need for Ventilator Support among Pediatric Patients with COVID-19 Infection

Background: This study aims to determine if coagulation abnormalities at presentation are associated with clinical severity of pediatric COVID-19 infection. Methods: We retrospectively reviewed admission coagulation studies (D-dimer, prothrombin time (PT), partial thromboplastin time with hepzyme, fibrinogen, and platelet count) with disease severity defined by need for ICU admission, ventilator support, and length of stay (LOS). Results: There were 110 pediatric patients (0.5 months to 18 years) who had coagulation studies collected within 24 hours of admission. Patients who required ICU admission and ventilation support had significantly higher D-dimer and PT values at presentation compared to patients who required neither. In addition, D-dimer showed moderate correlation with LOS. Conclusions: Elevated D-dimer correlated significantly with severity of disease and LOS, while prolonged PT only correlated with disease severity. Our data suggest that D-dimer at presentation may predict a pediatric patient’s need for ICU care or ventilator support.