Management of COVID-19-associated coagulopathy in persons with haemophilia.

Haemophilia : the Official Journal of the World Federation of Hemophilia
Steven W PipeCoagulation Products Safety, Supply and Access (CPSSA) Committee of the World Federation of Hemophilia

Abstract

The SARS-CoV-2 coronavirus-induced infection (COVID-19) can be associated with a coagulopathy mainly responsible for pulmonary microvasculature thrombosis and systemic thromboembolic manifestations. The pathophysiology and management of the COVID-19 coagulopathy are likely more complex in patients with inherited bleeding diseases such as haemophilia. These individuals might indeed present with both bleeding and thrombotic complications and require simultaneous antithrombotic and haemostatic treatments. We propose practical guidance for the diagnosis and management of COVID-19 coagulopathy in persons with haemophilia. Continuation of regular haemostatic treatment is recommended for ambulatory patients. For patients requiring hospital admission and on replacement therapy with factors VIII or IX concentrates, prophylaxis with concentrates should be intensified according to the risk of bleeding complications and associated with prophylactic doses of LMWH. For patients on nonreplacement therapy, emicizumab should be continued and possibly combined with factor VIII and prophylactic doses of LMWH depending on the risk of bleeding and thrombosis. Dose escalation of LMWH tailored to the risk of thrombosis can be employed but not support...Continue Reading

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Citations

Apr 30, 2021·Haemophilia : the Official Journal of the World Federation of Hemophilia·Donata Urbaniak-KujdaTomasz Wróbel
May 14, 2021·Haemophilia : the Official Journal of the World Federation of Hemophilia·Antonella ColucciaUNKNOWN AICE MECCOVID-19 Study Group

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Methods Mentioned

BETA
prophylactic therapy

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