612: INCIDENCE AND RISK OF PULMONARY EMBOLISM IN PEDIATRIC PATIENTS WITH ACUTE COVID-19 INFECTION

Introduction: Previous studies have reported an increased risk of procoagulant events such as pulmonary embolism (PE) in adult patients with Coronavirus Disease-19 (COVID-19). However, scant information exists within pediatric samples. This study aimed to investigate the effect of COVID-19 acute infections on the incidence of PE among pediatric patients. Methods: Using Virtual Pediatric Systems (VPS), retrospective data was collected of patients age < 18 years old who were admitted to participating pediatric critical care units from 2018-2021. Patients with an ICD diagnosis of COVID-19 infection or PE were extracted for further analysis. Additional information regarding patient age, gender, race, BMI, comorbidities were also obtained. Results: In total, there were 488,298 admissions to PICUS participating in VPS from 2018 – 2021. In 2018 and 2019, prior to the COVID-19 pandemic, the incidence of PE among the pediatric population was 2.29 per 1000 patients (n=614). During the COVID-19 pandemic in 2020-2021, the incidence of PE increased to 3.11 per 1000 patients (n=686). Of the PE cases between 2020 to 2021, 12.1% (n=83) patients had an acute COVID-19 infection (53.0% female; 42.0% BMI> 35; 91.6% >12 years of age; 92.8% survival). Patients with acute COVID-19 infection had 3.4 (95% CI, 2.7 – 4.2) times the risk of pulmonary embolism than patients from 2020 to 2021 without acute COVID-19 infection. Conclusions: In this study, we report an increased incidence of PE among pediatric patients during the COVID-19 pandemic when compared with the years prior to the pandemic. Additionally, we report a significantly increased relative risk of pulmonary embolism in patients with acute COVID-19 infection compared to patients without acute COVID-19 infection. Further analysis is planned to adjust for hypercoagulable states. Additional research is needed to identify risk factors for PE in pediatric patients with COVID-19.