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Table 3 Pediatric COVID-19 anticoagulation regimens

From: Practical approach to COVID-19: an Egyptian pediatric consensus

a. Doses of anticoagulation
  Prophylaxis Therapeutic dose
 Heparin 100–150 units/kg IV once Infusion
• < 1 year—loading dose of 75 units/kg IV, then 28 units/kg/h IV as initial maintenance dose
• 1 year—Loading dose of 75 units/kg IV, then 20 units/kg/h IV as initial maintenance dose
Intermittent IV injection
• Initially give 50–100 units/kg IV infusion, then 100 units/kg IV infusion q4hr as a maintenance dose
 Enoxaparin < 2 months: 0.75 mg/kg SC q12h
≥ 2 months: 0.5 mg/kg SC q12hr
< 2 months: 1.5 mg/kg SC q12h
≥ 2 months: 1 mg/kg SC q12hr
b. Indications and contraindications of anticoagulation
 Indications for prophylactic anticoagulation All admitted patients with moderate COVID-19, i.e., any patient with pneumonia
All moderate and severe cases who don't meet the therapeutic indications
 Indications for therapeutic anticoagulation All ICU patients
O2 sat < 92% or tachypnea for age
O2 requirements ≥ 4 L on nasal cannula
Elevated D-dimer 3x upper level of normal
Elevated CRP
 Contraindications Patients who are at high risk of bleeding
Platelets < 50,000
INR > 1.5
Active bleeding