{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:15:11Z","timestamp":1787022911032,"version":"build-2736575974"},"reference-count":56,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,1]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Evidence regarding the safety and efficacy of anticoagulant thromboprophylaxis among pediatric patients hospitalized for coronavirus disease 2019 (COVID-19) is limited. We sought to evaluate safety, dose-finding, and preliminary efficacy of twice-daily enoxaparin as primary thromboprophylaxis among children hospitalized for symptomatic COVID-19, including primary respiratory infection and multisystem inflammatory syndrome in children (MISC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We performed a phase 2, multicenter, prospective, open-label, single-arm clinical trial of twice-daily enoxaparin (initial dose: 0.5mg\/kg per dose; max: 60mg; target anti-Xa activity: 0.20\u20130.49IU\/mL) as primary thromboprophylaxis for children &amp;lt;18 years of age hospitalized for symptomatic COVID-19. Study endpoints included: cumulative incidence of International Society of Thrombosis and Haemostasis-defined clinically relevant bleeding; enoxaparin dose-requirements; and cumulative incidence of venous thromboembolism within 30-days of hospital discharge. Descriptive statistics summarized endpoint estimates that were further evaluated by participant age (\u00b112 years) and clinical presentation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Forty children were enrolled and 38 met analyses criteria. None experienced clinically relevant bleeding. Median (interquartile range) dose to achieve target anti-Xa levels was 0.5 mg\/kg (0.48\u20130.54). Dose-requirement did not differ by age (0.5 [0.46\u20130.52] mg\/kg for age \u226512 years versus 0.52 [0.49\u20130.55] mg\/kg for age &amp;lt;12 years, P = .51) but was greater for participants with MISC (0.52 [0.5\u20130.61] mg\/kg) as compared with primary COVID-19 (0.48 [0.39\u20130.51] mg\/kg, P = .010). Two children (5.3%) developed central-venous catheter-related venous thromboembolism. No serious adverse events were related to trial intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Among children hospitalized for COVID-19, thromboprophylaxis with twice-daily enoxaparin appears safe and warrants further investigation to assess efficacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2022-056726","type":"journal-article","created":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T01:08:25Z","timestamp":1651194505000},"source":"Crossref","is-referenced-by-count":35,"title":["Enoxaparin Thromboprophylaxis in Children Hospitalized for COVID-19: A Phase 2 Trial"],"prefix":"10.1542","volume":"150","author":[{"given":"Anthony A.","family":"Sochet","sequence":"first","affiliation":[{"name":"aDepartments of Anesthesia"},{"name":"bCritical Care Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Morrison","sequence":"additional","affiliation":[{"name":"aDepartments of Anesthesia"},{"name":"cPediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Jaffray","sequence":"additional","affiliation":[{"name":"hDepartment of Pediatrics, Children\u2019s Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nihal","family":"Godiwala","sequence":"additional","affiliation":[{"name":"iDepartment of Pediatrics, Louisiana State University School of Medicine, New Orleans, Louisiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hope P.","family":"Wilson","sequence":"additional","affiliation":[{"name":"jDepartment of Pediatrics, University of Alabama School of Medicine, Birmingham, Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney D.","family":"Thornburg","sequence":"additional","affiliation":[{"name":"kDepartment of Pediatrics, University of California San Diego, La Jolla, California Division of Hematology and Oncology, Rady Children\u2019s Hospital San Diego, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rukhmi V.","family":"Bhat","sequence":"additional","affiliation":[{"name":"lDepartment of Pediatrics, Ann and Robert H. Lurie Children\u2019s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayesha","family":"Zia","sequence":"additional","affiliation":[{"name":"mDepartment of Pediatrics, The University of Texas Southwestern, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney","family":"Lawrence","sequence":"additional","affiliation":[{"name":"cPediatrics"},{"name":"dPathology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sapna R.","family":"Kudchadkar","sequence":"additional","affiliation":[{"name":"bCritical Care Medicine"},{"name":"cPediatrics"},{"name":"gPhysical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances","family":"Hamblin","sequence":"additional","affiliation":[{"name":"aDepartments of Anesthesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"Russell","sequence":"additional","affiliation":[{"name":"hDepartment of Pediatrics, Children\u2019s Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael B.","family":"Streiff","sequence":"additional","affiliation":[{"name":"eMedicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex C.","family":"Spyropoulos","sequence":"additional","affiliation":[{"name":"nDepartment of Medicine, Zucker School of Medicine at Hofstra and Northwell and Feinstein Institutes for Medical Research, Manhasset, New York"},{"name":"oDepartment of Obstetrics and Gynecology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernest K.","family":"Amankwah","sequence":"additional","affiliation":[{"name":"aDepartments of Anesthesia"},{"name":"cPediatrics"},{"name":"fOncology, Johns Hopkins All Children's Institute for Clinical and Translational Research"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil A.","family":"Goldenberg","sequence":"additional","affiliation":[{"name":"aDepartments of Anesthesia"},{"name":"cPediatrics"},{"name":"eMedicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"COVID-19 Anticoagulation in Children \u2013 Thromboprophylaxis (COVAC-TP) Trial Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2022,6,29]]},"reference":[{"key":"2023110816084172400_B1","unstructured":"The World Health Organization\n          . 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