Defibrotide for the Treatment of Pediatric Inflammatory Multisystem Syndrome Temporally Associated With Severe Acute Respiratory Syndrome Coronavirus 2 Infection in 2 Pediatric Patients

J Pediatric Infect Dis Soc. 2020 Nov 10;9(5):622-625. doi: 10.1093/jpids/piaa117.

Abstract

The pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 infection is a severe complication of coronavirus disease 2019. Since impaired coagulation and thrombosis/endotheliitis are suspected pathomechanisms, we treated 2 patients with defibrotide, a profibrinolytic, antithrombotic, antiinflammatory oligonucleotide. Symptoms resolved during treatment. Moreover, coagulation parameters indicating hypofibrinolysis and complement activation normalized. The pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 infection is a severe complication of coronavirus disease 2019. Since impaired coagulation and thrombosis/endotheliitis are suspected pathomechanisms, 2 patients received defibrotide, a profibrinolytic, antithrombotic, antiinflammatory oligonucleotide. Symptoms resolved and hypofibrinolysis/complement activation normalized during treatment.

Keywords: children; complement; coronavirus disease 2019; defibrotide; endotheliitis.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / etiology
  • Adolescent
  • Betacoronavirus
  • Blood Coagulation Factors / analysis
  • COVID-19
  • Child
  • Coronavirus Infections / complications*
  • Coronavirus Infections / diagnosis
  • Female
  • Fever / etiology
  • Humans
  • Pandemics
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / diagnosis
  • Polydeoxyribonucleotides / therapeutic use*
  • SARS-CoV-2
  • Systemic Inflammatory Response Syndrome / blood
  • Systemic Inflammatory Response Syndrome / drug therapy*
  • Systemic Inflammatory Response Syndrome / immunology
  • T-Lymphocytes / immunology

Substances

  • Blood Coagulation Factors
  • Platelet Aggregation Inhibitors
  • Polydeoxyribonucleotides
  • defibrotide

Supplementary concepts

  • pediatric multisystem inflammatory disease, COVID-19 related