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Clinical Course of COVID-19 in Patients with Inherited Bleeding Disorders: An Interim Analysis of 28 Cases

A. Sikorska1, E. Stefanska-Windyga2, J. Windyga1

1Department of Hemostasis Disorders and Internal Medicine, Institute of Hematology and Transfusion Medicine, Warsaw, Poland, 2Outpatient Clinic for People with Disorders of Hemostasis, Institute of Hematology and Transfusion Medicine, Warsaw, Poland

Abstract Number: PB0260

Meeting: ISTH 2021 Congress

Theme: COVID and Coagulation » COVID and Coagulation, Clinical

Background: The clinical course of  severe respiratory syndrome Coronavirus 2 (SARS-CoV-2)  in persons  with haemophilia (PWH) and other congenital bleeding disorders (CBD) is not fully recognized despite worldwide spread of  the disease.

Aims: The study aim was to describe the clinical course of COVID-19 in PWH and other CBD.  

Methods: Between October 2020 and February 2021 we identified 28 cases of Coronavirus Disease 2019 (COVID-19) among PWH and other CBD treated in our Centre. COVID-19 was PCR confirmed in all.

Results: Of 28 patients  aged 19-76 (median 46)  enrolled in the study, 17 (61%) had severe haemophilia A [5 with factor (F) VIII inhibitor], 3 – non-severe haemophilia A, 1 – severe haemophilia B, 5 – von Willebrand Disease, 1 – FVII deficiency, 1 – hypofibrinogenemia. At  COVID-19 diagnosis the underlying bleeding disorder was treated with long-term prophylaxis in 18/28 (64%) patients (the remaining patients were treated on-demand). Conditions/comorbidities that put our study patients at higher risk of severe COVID-19 were arterial hypertension (11/28, 39%), diabetes mellitus (3/28, 11%), obesity (5/28, 18%). COVID-19 was mild in 27/28 (96%) patients who required no hospitalization. For those  patients no changes in therapy of underlying bleeding disorder were introduced with 5 exceptions:prophylaxis was intensified (n=2), reduced (n=2) or temporarily discontinued (n=1). One severe haemophilia A patient without FVIII inhibitor (obese, arterial hypertension) required hospitalization in ICU for respiratory failure. He received low-molecular weight heparin for thromboprophylaxis (half therapeutic dose) with daily FVIII (35 IU/kg) replacement with no bleeding/thrombotic complications. All patients recovered with no bleeding/thrombotic complications. Several weeks after recovery from COVID-19  cardiac arrhythmia was identified In 2 patients.        

Conclusions: The course of COVID-19 in most patients with haemophilia and allied disorders was  mild with no significant impact on the therapy of the underlying bleeding disorder.

To cite this abstract in AMA style:

Sikorska A, Stefanska-Windyga E, Windyga J. Clinical Course of COVID-19 in Patients with Inherited Bleeding Disorders: An Interim Analysis of 28 Cases [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/clinical-course-of-covid-19-in-patients-with-inherited-bleeding-disorders-an-interim-analysis-of-28-cases/. Accessed May 16, 2022.

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