Bleeding and Bleeding Risk in COVID-19

Abstract

This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.

Patients with Congenital Bleeding Disorders Appear to be Less Severely Affected by SARS-CoV-2: Is Inherited Hypocoagulability Overcoming Acquired Hypercoagulability of Coronavirus Disease 2019 (COVID-19)?

“…Some authors suggest mild anticoagulant therapy, whereas others prefer more aggres-sive therapeutic strategies. 7 Nevertheless, although our data are important, these observations are only confined to a limited number of patients with CBDs; however, they warrant further, more extended studies, including our ongoing study on a large number of patients with CBDs, which should then resolve some of the ambiguities this report presents.…”

“…Gastrointestinal bleeding, the most common hemorrhagic manifestation in COVID-19, has been reported with a frequency of 4 to 13.7%, mostly in severely affected patients. 7 In this study, only two patients with contributing risk factors experienced bleeding during COVID-19 infection, even including those with severe factor deficiencies. An interesting evidence that emerged from this study is the absence of thrombotic events in seven patients with moderate-to-severe factor deficiencies.…”

Obstetric Hemorrhage Risk Associated with Novel COVID-19 Diagnosis from a Single-Institution Cohort in the United States

“…[12][13][14][15] One case series found coagulopathy-indicating laboratory markers in two pregnant patients; only one of the patients had a delivery associated with postpartum hemorrhage. 4 Furthermore, while reviews and case reports in nonpregnant populations have reported some severe morbidity and even mortality in COVID-19 associated with bleeding or hemorrhage, [1][2][3][4] there have been very limited data regarding specific laboratory derangements that may be predictive for or associated with bleeding risk related to COVID-19. [16][17][18] Further research should continue to investigate the impact of a COVID-19 diagnosis on hematologic physiology, and also its impact specifically in the setting of pregnancy.…”

“…Early case reports in the general population have demonstrated severe morbidities from coagulopathies and bleeding disorders associated with novel coronavirus disease 2019 (COVID-19) infection. [1][2][3] Based on cases in pregnancy, it has been suggested that exacerbation of the immunologic shift of pregnancy combined with the cytokine storm provoked by COVID-19 infection could hasten consumptive coagulopathy. 4 However, with very few studies reporting the blood loss associated with COVID-19 deliveries, there is a void of robust data to direct clinical practice.…”

Maintaining Hemostasis and Preventing Thrombosis in Coronavirus Disease 2019 (COVID-19)—Part I

“…This issue of STH then turns away from the prothrombotic side of COVID-19 to explore the less well investigated "bleeding side" of COVID-19. Dr. Dorgalaleh starts the discussion with a commentary on bleeding and bleeding risk in COVID-19, 18 advising that although hypercoagulability and thrombotic events are common in COVID-19, bleeding may occur at any time during the course of disease. Several factors make patients with COVID-19 prone to bleeding, including thrombocytopenia, hyperfibrinolytic state, consumption of coagulation factors, and thromboprophylactic administration of anticoagulants.…”