Thrombosis within the microvasculature and medium to large vessels is a
serious and common complication among critically ill individuals with
COVID-19. While children are markedly less likely to develop severe
disease than adults, they remain at risk for thrombosis during acute
infection and with the post-acute inflammatory illness termed
multisystem inflammatory syndrome in children. Significant knowledge
deficits in understanding COVID-19 associated coagulopathy and
thrombotic risk pose clinical challenges for pediatric providers who
must incorporate expert opinion and personal experience to manage
individual patients. We discuss clinical scenarios to provide framework
for characterizing thrombosis risk and thromboprophylaxis in children
with COVID-19.