Challenges and concerns of patients with congenital bleeding disorders affected by coronavirus disease 2019

Dorgalaleh, Akbar; Tabibian, Shadi; Baghaipour, Mohammad Reza; Dabbagh, Ali; Bahoush, Gholamreza; Jazebi, Mohammad; Bahraini, Mehran; Fazeli, Alieh; Yousefi, Farzad

doi:10.1097/mbc.0000000000001019

Cited by 3 publications

(9 citation statements)

References 11 publications

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“…Studies have shown that the COVID-19 pandemic had a negative impact on lifestyle behaviors, routine care, and replacement therapies in patients with CBD [15][16][17][18]. However, there are only a limited number of clinical studies that have investigated the outcomes of COVID-19 in patients with bleeding disorders, and it is not known whether patients with bleeding disorders are more or less prone to the severe form of infection.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of COVID-19 in Adult Males With Hemophilia A: A Propensity Score-Matched Analysis

Mericliler¹,

Narayan²

2022

Cureus

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BackgroundHypercoagulability is a major pathologic event in COVID-19. Factor VIII plays an important role in hemostasis, and high levels of factor VIII have been shown to be associated with an increased risk of thrombosis and severe disease. Little is known about the impact of COVID-19 on clinical outcomes in patients with hemophilia A. MethodologyRetrospective data of adult male patients with COVID-19 with and without hemophilia A were retrieved from the TriNetX database (Cambridge, USA). The 1:1 propensity score-matching was performed to balance baseline characteristics. Patients were matched for age, race, body mass index, and medical comorbidities. Thirty-day outcomes were assessed. ResultsWe identified 1,758 patients with pre-existing hemophilia A diagnosis prior to COVID-19 diagnosis and 5,191,908 comparators. After 1:1 propensity score matching, groups were balanced on demographics and comorbidities. All-cause mortality rates were similar between the two groups (HR 0.805; 95% CI 0.467-1.389). The frequency of severe infection, ICU admission, and composite thrombotic events did not differ between the groups. Patients with hemophilia A were hospitalized more frequently than those without a history of hemophilia A (19.2% vs. 14.4%; p<0.05). Additionally, gastrointestinal (GI) bleeding and composite bleeding events occurred more frequently in patients with hemophilia A (3.2% vs. 2.2%; p<0.05 and 4.0% vs. 2.8%; p<0.05, respectively). ConclusionsThe mortality of individuals with hemophilia A due to COVID-19 is comparable to the general population but with higher risks of hospitalization and bleeding.

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Section: Discussionmentioning

confidence: 99%

Outcomes of COVID-19 in Adult Males With Hemophilia A: A Propensity Score-Matched Analysis

Mericliler¹,

Narayan²

2022

Cureus

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“…In addition to these concerns and complications, the impact of COVID-19 on the hemostasis system has presented further challenges for both patients and their health care providers. 5 6 7…”

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confidence: 99%

“…3,4 In addition to the wellknown risk factors, some studies have also examined the impact of COVID-19 on patients with congenital bleeding disorders (CBDs). [5][6][7][8] The pandemic has affected the lives of patients with CBDs more severely than those of the general population. 5 Similar to patients with other chronic diseases such as cancer, diabetes mellitus, thalassemia, and others, most patients with CBDs assume that they are at a higher risk of severe COVID-19 outcomes compared with healthy individuals.…”

mentioning

confidence: 99%

Congenital Bleeding Disorders and COVID-19—A Systematic Literature Review

Dorgalaleh,

Safdari,

Tabibian

et al. 2023

Semin Thromb Hemost

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Hypercoagulability is a prominent feature of coronavirus disease 2019 (COVID-19) and can lead to fatal consequences. Although the impact of COVID-19 on several disorders is well-established, its effect on congenital bleeding disorders (CBDs) is not well-documented. To address this ambiguity, a systematic review was conducted on the available studies to determine the impact of COVID-19 and vaccination aimed to prevent COVID-19 on patients with CBDs. We performed a systematic literature review using relevant keywords and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) protocol. We conducted our search on the PubMed, Scopus, and Web of Science databases until July 2023. Out of 31 included studies, 12 case series covering 770 patients with CBD and COVID-19 were further analyzed. The majority of the patients had hemophilia A (n = 352, ∼46%) or hemophilia B (n = 74, ∼10%), while the remaining patients had von Willebrand disease (n = 43, 5.6%) or rare bleeding disorders (n = 27, 3.5%). A total of 25 deaths (3.2%) and 22 intensive care unit admissions (2.8%) were recorded. Bleeding complications were reported in the majority of the 12 case series (n = 7, 58.3%) and in most of the case reports (n = 8, ∼57%), while thrombotic complications were only reported in two studies (16.6%). The mortality rate ranged from 0% in five studies (41.6%) to 5.7% and the rate of hospitalization ranged from 0 to 40%. Bleeding complications were reported in a range of 0 to 81%, while the thrombotic complication rate in one study was 6.9%. The mortality rate varied from 0 to 5.7%, and the hospitalization rate ranged from 0 to 40%. Bleeding complications were reported in a range of 0 to 81%, while the rate of thrombotic complications in one study was 6.9%. Vaccination was reported in five case series, which included 821 patients with CBDs with the majority having hemophilia A (n = 479; 67.2%) and hemophilia B (n = 85; ∼12%). The most frequently reported side effects were myalgia (6.5%), flu-like symptoms (4.8%), fever (4.7%), and headache (4%). COVID-19 in patients with CBDs appears to provoke thrombotic complications and bleeding events more frequently, as well as a higher rate of hospitalization, which may be partially due to the increased risk of bleeding events. Although it seems that patients with CBD have lower mortality rates, further studies are necessary to fully understand this, especially considering comorbidities and low number of available studies.

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“…The authors state that COVID‐19 infection has great consequences on the lives of patients with CBDs and caused abandonment of their treatment. 8 …”

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confidence: 99%

“…The authors state that COVID-19 infection has great consequences on the lives of patients with CBDs and caused abandonment of their treatment. 8 A study, as presented at the EAHAD congress in 2021, 9 was carried out with PWH (N = 45) and healthcare professionals (N = 24) in the Czech Republic and United Kingdom. They responded to 24 questions.…”

mentioning

confidence: 99%

Impact of COVID‐19 on professionals and patients in haemophilia care – The perspective from the EAHAD Psychosocial Working Group

Burgess¹,

Buckova

Vandenabeele

et al. 2022

Haemophilia

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Challenges and concerns of patients with congenital bleeding disorders affected by coronavirus disease 2019

Cited by 3 publications

References 11 publications

Outcomes of COVID-19 in Adult Males With Hemophilia A: A Propensity Score-Matched Analysis

Outcomes of COVID-19 in Adult Males With Hemophilia A: A Propensity Score-Matched Analysis

Congenital Bleeding Disorders and COVID-19—A Systematic Literature Review

Impact of COVID‐19 on professionals and patients in haemophilia care – The perspective from the EAHAD Psychosocial Working Group

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