How haemophilia A impacts severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) treatment: a case report

J Thromb Thrombolysis. 2020 Nov;50(4):795-798. doi: 10.1007/s11239-020-02227-z. Epub 2020 Jul 16.

Abstract

The typical symptoms of COVID-19 mimic those of the common season flu. In addition, several changes in the coagulation processes have been observed. To date, it's not fully clear how COVID-19 may affect patients with hereditary bleeding disorders. Anticoagulation in patients with haemophilia is still debated, but in this case could be needed. We are reporting a case of an elderly patient with mild haemophilia A hospitalized for Sars-Cov-2. On the 15th day of hospitalization, we observed an increase of all coagulation parameters. An antithrombotic prophylaxis at low dosage was immediately started, then increased at prophylactic dosage. Even if much more data are needed to ascertain the real thrombotic risk of haemophilia A in COVID-19 patients, it's clear that the FVIII and vWF should be strictly monitored in order to promptly establish an adequate treatment and avoid the onset of thromboembolic events, even fatal, causing many deaths in COVID-19 patients.

Keywords: Bleeding disorders; COVID-19; Coagulation; Coronavirus; Haemophilia A; SARS-Cov-2.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Betacoronavirus / pathogenicity
  • Blood Coagulation / drug effects*
  • COVID-19
  • Coronavirus Infections / blood
  • Coronavirus Infections / complications
  • Coronavirus Infections / therapy*
  • Coronavirus Infections / virology
  • Enoxaparin / administration & dosage*
  • Enoxaparin / adverse effects
  • Female
  • Fibrinolytic Agents / administration & dosage*
  • Fibrinolytic Agents / adverse effects
  • Hemophilia A / blood
  • Hemophilia A / complications*
  • Host-Pathogen Interactions
  • Humans
  • Pandemics
  • Pneumonia, Viral / blood
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / therapy*
  • Pneumonia, Viral / virology
  • SARS-CoV-2
  • Thrombosis / blood
  • Thrombosis / diagnosis
  • Thrombosis / prevention & control*
  • Thrombosis / virology
  • Treatment Outcome

Substances

  • Enoxaparin
  • Fibrinolytic Agents