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Dorgalaleh A, Safdari SM, Tabibian S, Shams M, Dabbagh A, Rezazadeh A. Congenital Bleeding Disorders and COVID-19-A Systematic Literature Review. Semin Thromb Hemost 2024; 50:552-568. [PMID: 37758179 DOI: 10.1055/s-0043-1775733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
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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Affiliation(s)
| | - Seyed Mehrab Safdari
- Departments of Hematology and Blood Transfusion, School of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Shadi Tabibian
- Iranian Comprehensive Hemophilia Care Center, Blood and Viral Research Center, Tehran, Iran
| | - Mahmood Shams
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Ali Dabbagh
- Department of Anesthesia and Anesthesia Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azadeh Rezazadeh
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
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Wilson R, Ko C, Kashyap R. COVID-19 in the Setting of HIV and Severe Hemophilia A: A Case Report. HCA HEALTHCARE JOURNAL OF MEDICINE 2024; 5:145-150. [PMID: 38984227 PMCID: PMC11229595 DOI: 10.36518/2689-0216.1615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
Introduction A hyperactive immune response is the driving force behind severe Coronavirus disease 2019 (COVID-19). Complications of severe COVID-19 include acute respiratory distress syndrome, acute respiratory failure, and increased risk of venous thromboembolism (VTE). The management of patients with COVID-19 includes respiratory support, decreasing immune response to the virus to prevent the progression of disease, and anticoagulation to prevent VTE. Case Presentation We present the case of a patient with a history of human immunodeficiency virus (HIV) and hemophilia A admitted with COVID-19. This case demonstrates the difficulties present when managing COVID-19 in patients with specific comorbidities. Anticoagulation is a recommended component of COVID-19 treatment but is contraindicated in patients with severe hemophilia due to increased risk for bleeding. Research has also shown that dexamethasone decreases mortality in patients with COVID-19, but doctors should use dexamethasone cautiously in patients with HIV since it is an immunosuppressant. Taking certain antiretroviral therapies, such as rilpivirine, also contraindicates the use of dexamethasone. Conclusion In this case, it is important to monitor for the risk and presence of superimposed bacterial or opportunistic infections. Treating a patient with these comorbidities who is infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) highlights the importance of balancing the risks and benefits.
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Affiliation(s)
- Ryan Wilson
- TriStar Southern Hills Medical Center, Nashville, TN
| | - Chae Ko
- TriStar Southern Hills Medical Center, Nashville, TN
| | - Rahul Kashyap
- TriStar Southern Hills Medical Center, Nashville, TN
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Sharathkumar A, Wendt L, Ortman C, Srinivasan R, Chute CG, Chrischilles E, Takemoto CM. COVID-19 outcomes in persons with hemophilia: results from a US-based national COVID-19 surveillance registry. J Thromb Haemost 2024; 22:61-75. [PMID: 37182697 PMCID: PMC10181864 DOI: 10.1016/j.jtha.2023.04.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/29/2023] [Accepted: 04/25/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Hypercoagulable state contributing to thrombotic complications worsens COVID-19 severity and outcomes, whereas anticoagulation improves outcomes by alleviating hypercoagulability. OBJECTIVES To examine whether hemophilia, an inherent hypocoagulable condition, offers protection against COVID-19 severity and reduces venous thromboembolism (VTE) risk in persons with hemophilia (PwH). METHODS A 1:3 propensity score-matched retrospective cohort study used national COVID-19 registry data (January 2020 through January 2022) to compare outcomes between 300 male PwH and 900 matched controls without hemophilia. RESULTS Analyses of PwH demonstrated that known risk factors (older age, heart failure, hypertension, cancer/malignancy, dementia, and renal and liver disease) contributed to severe COVID-19 and/or 30-day all-cause mortality. Non-central nervous system bleeding was an additional risk factor for poor outcomes in PwH. Odds of developing VTE with COVID-19 in PwH were associated with pre-COVID VTE diagnosis (odds ratio [OR], 51.9; 95% CI, 12.8-266; p < .001), anticoagulation therapy (OR, 12.7; 95% CI, 3.01-48.6; p < .001), and pulmonary disease (OR, 16.1; 95% CI, 10.4-25.4; p < .001). Thirty-day all-cause mortality (OR, 1.27; 95% CI, 0.75-2.11; p = .3) and VTE events (OR, 1.32; 95% CI, 0.64-2.73; p = .4) were not significantly different between the matched cohorts; however, hospitalizations (OR, 1.58; 95% CI, 1.20-2.10; p = .001) and non-central nervous system bleeding events (OR, 4.78; 95% CI, 2.98-7.48; p < .001) were increased in PwH. In multivariate analyses, hemophilia did not reduce adverse outcomes (OR, 1.32; 95% CI, 0.74-2.31; p = .2) or VTE (OR, 1.14; 95% CI, 0.44-2.67; p = .8) but increased bleeding risk (OR, 4.70; 95% CI, 2.98-7.48; p < .001). CONCLUSION After adjusting for patient characteristics/comorbidities, hemophilia increased bleeding risk with COVID-19 but did not protect against severe disease and VTE.
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Affiliation(s)
- Anjali Sharathkumar
- Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA.
| | - Linder Wendt
- Institute for Clinical and Translational Science, University of Iowa, Iowa City, Iowa, USA
| | - Chris Ortman
- Department of Bioinformatics, University of Iowa, Iowa City, Iowa, USA; Department of Hematology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Ragha Srinivasan
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | | | - Elizabeth Chrischilles
- Department of Bioinformatics, University of Iowa, Iowa City, Iowa, USA; Department of Epidemiology, School of Public Health, University of Iowa, Iowa, USA
| | - Clifford M Takemoto
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
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Onishi T, Harada S, Shimo H, Tashiro Y, Soeda T, Nogami K. The in vitro effect of anticoagulant agents on coagulation and fibrinolysis in the presence of emicizumab in the plasmas from patients with haemophilia A. Haemophilia 2023; 29:1529-1538. [PMID: 37766492 DOI: 10.1111/hae.14877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/11/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023]
Abstract
INTRODUCTION Emicizumab is used as hemostatic prophylaxis for patients with hemophilia A (PwHA), irrespective of the presence of inhibitors. Although bacterial infection can lead to a procoagulant state, there is limited information on coagulation and fibrinolysis potentials in emicizumab-treated PwHA and on the use of anticoagulants in such cases. AIM We examined whether anticoagulants affect the coagulation and fibrinolysis potentials in plasma from PwHA spiked with emicizumab. METHODS Plasma from PwHA was in vitro supplemented with emicizumab (50 μg/mL; emi-plasma) and anticoagulants (recombinant thrombomodulin (rTM), nafamostat mesylate (NM), unfractionated heparin (UFH), or low-molecular-weight heparin (LMH)). PwHA plasma spiked with rFVIII (1 IU/mL) was used as a reference (ref-plasma). The coagulation and fibrinolysis potentials in plasma was measured by thrombin and plasmin generation assay (T/P-GA) and clot-fibrinolysis waveform analysis (CFWA). RESULTS In T/P-GA and CFWA, coagulation potentials (maximum coagulation velocity; |min1|, and peak thrombin; Th-Peak) in plasma rose with increasing concentrations of emicizumab and rFVIII, but fibrinolytic potentials (peak plasmin; Plm-Peak, and maximum fibrinolytic velocity; |FL-min1|) remained unchanged. Adding rTM, NM, and UFH to emi-plasma suppressed coagulation and fibrinolysis potentials, similar to ref-plasma. Regarding the heparin, UFH and LMH inhibited the improved coagulation in emi-plasma. UFH inhibited fibrinolysis as well, but LMH did not. CONCLUSIONS Anticoagulants could exhibit the inhibitory effects on the coagulation and fibrinolysis potentials in plasma from PwHA spiked with emicizumab, similar to those in normal plasma.
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Affiliation(s)
- Tomoko Onishi
- Department of Pediatrics, Nara Medical University, Kashihara, Nara, Japan
| | - Suguru Harada
- Chugai Pharmaceutical Co., Ltd., Yokohama, Kanagawa, Japan
| | - Hanako Shimo
- Department of Pediatrics, Nara Medical University, Kashihara, Nara, Japan
| | | | | | - Keiji Nogami
- Department of Pediatrics, Nara Medical University, Kashihara, Nara, Japan
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Houssiau H, Hermans C. Successful in-patient management of COVID-19 infection in an old severe haemophilia A patient on emicizumab with multiple prothrombotic comorbidities. Haemophilia 2023; 29:674-675. [PMID: 36639948 DOI: 10.1111/hae.14743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/12/2022] [Accepted: 01/02/2023] [Indexed: 01/15/2023]
Affiliation(s)
- Hélène Houssiau
- Division of Haematology, Haemostasis and Thrombosis Unit, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Cedric Hermans
- Division of Haematology, Haemostasis and Thrombosis Unit, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
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Mazurkiewicz Ł, Czernikiewicz K, Rupa-Matysek J, Gil L. Emicizumab: a novel drug in hemophilia A prophylaxis - a narrative review. Expert Rev Hematol 2022; 15:933-942. [PMID: 36191306 DOI: 10.1080/17474086.2022.2131526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Hemophilia A is a genetically conditioned disease leading to hemostatic disorders due to factor VIII (FVIII) deficiency. The treatment of hemophilia has evolved throughout the past years and has significantly changed. One of the newest drugs for prophylactic treatment is the humanized bispecific IgG antibody - emicizumab, which binds with factor IXa and factor X, bridging those factors and thus mimicking the activity of factor VIII. AREAS COVERED The literature search was made via PubMed database, with the emphasis on clinical trials and case reports, describing the off-label emicizumab use. This review presents an extensive summary and considers advantages and disadvantages (side-effects) of emicizumab, describing additional clinical situations, where emicizumab has been successfully used. In our review we cover information about the mechanisms of action, indications, efficacy and discuss some chosen case reports about off-label emicizumab use. EXPERT OPINION Its convenient administration method (subcutaneous) and frequency of injections (from once a week to once a month) makes it a more comfortable treatment, limiting injection-site reactions, hospital stays, costs of prophylaxis, and significantly increasing patients' quality of life. Adverse effects are scarce and rarely serious - the most common ones are reactions at the injection-site and upper respiratory tract infections.
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Affiliation(s)
- Łukasz Mazurkiewicz
- Department of Hematology and Bone Marrow Transplantation, Poznań University of Medical Sciences, Poznań, Poland
| | - Krystian Czernikiewicz
- Department of Hematology and Bone Marrow Transplantation, Poznań University of Medical Sciences, Poznań, Poland
| | - Joanna Rupa-Matysek
- Department of Hematology and Bone Marrow Transplantation, Poznań University of Medical Sciences, Poznań, Poland
| | - Lidia Gil
- Department of Hematology and Bone Marrow Transplantation, Poznań University of Medical Sciences, Poznań, Poland
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Coluccia A, Marchesini E, Giuffrida AC, Rivolta GF, Ricca I, Zanon E, Luciani M, De Cristofaro R, Coppola A, Rocino A. Addressing the impact of SARS-CoV-2 infection in persons with congenital bleeding disorders: The Italian MECCOVID-19 study. Haemophilia 2021; 27:e575-e578. [PMID: 33982839 PMCID: PMC8239798 DOI: 10.1111/hae.14331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 04/16/2021] [Accepted: 04/23/2021] [Indexed: 12/04/2022]
Affiliation(s)
- Antonella Coluccia
- Centre for Haemophilia and Rare Bleeding Disorders, Unit of Internal Medicine, Scorrano Hospital, ASL Lecce, Scorrano, Italy
| | - Emanuela Marchesini
- Haemophilia Centre, Vascular and Emergency Medicine, S. Maria della Misericordia Hospital, Perugia, Italy
| | - Anna Chiara Giuffrida
- Haemophilia Centre, Transfusion Medicine Unit, Integrated University Hospital of Verona, Verona, Italy
| | - Gianna Franca Rivolta
- Regional Reference Centre for Inherited Bleeding Disorders, University Hospital of Parma, Parma, Italy
| | - Irene Ricca
- Haemophilia Centre, Immune-Haematology and Transfusion Medicine, University Hospital "Città della Salute e della Scienza", Turin, Italy
| | - Ezio Zanon
- Haemophilia Centre, Department of Medicine, University Hospital of Padua, Padua, Italy
| | - Matteo Luciani
- Haemophilia Centre, Bambino Gesù Paediatric Hospital, Rome, Italy
| | - Raimondo De Cristofaro
- Centre for Haemorrhagic and Thrombotic Disorders, A. Gemelli University Hospital Foundation, Rome, Italy
| | - Antonio Coppola
- Regional Reference Centre for Inherited Bleeding Disorders, University Hospital of Parma, Parma, Italy
| | - Angiola Rocino
- Haemophilia and Thrombosis Centre, Haematology, Ospedale del Mare, Naples, Italy
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Urbaniak-Kujda D, Biernat MM, Skalec T, Jacków-Nowicka J, Windyga J, Wróbel T. Successful treatment of COVID-19 in a patient with severe haemophilia A on emicizumab prophylaxis in the intensive care unit. Haemophilia 2021; 27:e567-e570. [PMID: 33915601 PMCID: PMC8239651 DOI: 10.1111/hae.14326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/09/2021] [Accepted: 04/14/2021] [Indexed: 12/27/2022]
Affiliation(s)
- Donata Urbaniak-Kujda
- Department of Haematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Monika Maria Biernat
- Department of Haematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Tomasz Skalec
- Department of Anaesthesiology and Intensive Therapy, Wroclaw Medical University, Wrocław, Poland
| | | | - Jerzy Windyga
- Department of Hemostasis Disorders and Internal Medicine, Laboratory of Hemostasis and Metabolic Diseases, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Tomasz Wróbel
- Department of Haematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
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Mutiawati E, Fahriani M, Mamada SS, Fajar JK, Frediansyah A, Maliga HA, Ilmawan M, Emran TB, Ophinni Y, Ichsan I, Musadir N, Rabaan AA, Dhama K, Syahrul S, Nainu F, Harapan H. Anosmia and dysgeusia in SARS-CoV-2 infection: incidence and effects on COVID-19 severity and mortality, and the possible pathobiology mechanisms - a systematic review and meta-analysis. F1000Res 2021; 10:40. [PMID: 33824716 PMCID: PMC7993408 DOI: 10.12688/f1000research.28393.1] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/06/2021] [Indexed: 02/06/2023] Open
Abstract
Background: The present study aimed to determine the global prevalence of anosmia and dysgeusia in coronavirus disease 2019 (COVID-19) patients and to assess their association with severity and mortality of COVID-19. Moreover, this study aimed to discuss the possible pathobiological mechanisms of anosmia and dysgeusia in COVID-19. Methods: Available articles from PubMed, Scopus, Web of Science, and preprint databases (MedRxiv, BioRxiv, and Researchsquare) were searched on November 10th, 2020. Data on the characteristics of the study (anosmia, dysgeusia, and COVID-19) were extracted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Newcastle-Ottawa scale was used to assess research quality. Moreover, the pooled prevalence of anosmia and dysgeusia were calculated, and the association between anosmia and dysgeusia in presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was assessed using the Z test. Results: Out of 32,142 COVID-19 patients from 107 studies, anosmia was reported in 12,038 patients with a prevalence of 38.2% (95% CI: 36.5%, 47.2%); whereas, dysgeusia was reported in 11,337 patients out of 30,901 COVID-19 patients from 101 studies, with prevalence of 36.6% (95% CI: 35.2%, 45.2%), worldwide. Furthermore, the prevalence of anosmia was 10.2-fold higher (OR: 10.21; 95% CI: 6.53, 15.96, p < 0.001) and that of dysgeusia was 8.6-fold higher (OR: 8.61; 95% CI: 5.26, 14.11, p < 0.001) in COVID-19 patients compared to those with other respiratory infections or COVID-19 like illness. To date, no study has assessed the association of anosmia and dysgeusia with severity and mortality of COVID-19. Conclusion: Anosmia and dysgeusia are prevalent in COVID-19 patients compared to those with the other non-COVID-19 respiratory infections. Several possible mechanisms have been hypothesized; however, future studies are warranted to elucidate the definitive mechanisms of anosmia and dysgeusia in COVID-19. Protocol registration: PROSPERO CRD42020223204.
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Affiliation(s)
- Endang Mutiawati
- Department of Neurology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia
- Department of Neurology, Dr. Zainoel Abidin Hospital, Banda Aceh, Aceh, 23111, Indonesia
| | - Marhami Fahriani
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia
| | - Sukamto S. Mamada
- Faculty of Pharmacy, Hasanuddin University, Makassar, South Sulawesi, 90245, Indonesia
| | - Jonny Karunia Fajar
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, 65145, East Java, Indonesia
| | - Andri Frediansyah
- Research Division for Natural Product Technology (BPTBA), Indonesian Institute of Sciences (LIPI), Wonosari, 55861, Indonesia
| | | | - Muhammad Ilmawan
- Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65117, Indonesia
| | - Talha Bin Emran
- Department of Pharmacy, BGC Trust University Bangladesh, Chittagong-4381, Bangladesh
| | - Youdiil Ophinni
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, 02139, USA
| | - Ichsan Ichsan
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia
- Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia
| | - Nasrul Musadir
- Department of Neurology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia
- Department of Neurology, Dr. Zainoel Abidin Hospital, Banda Aceh, Aceh, 23111, Indonesia
| | - Ali A. Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, 31311, Saudi Arabia
| | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India
| | - Syahrul Syahrul
- Department of Neurology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia
- Department of Neurology, Dr. Zainoel Abidin Hospital, Banda Aceh, Aceh, 23111, Indonesia
| | - Firzan Nainu
- Faculty of Pharmacy, Hasanuddin University, Makassar, South Sulawesi, 90245, Indonesia
| | - Harapan Harapan
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia
- Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia
- Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia
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10
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Vagrecha A, Stanco J, Majeed S, Kouides P, Acharya SS. Primary thromboprophylaxis in a patient with type 3 von Willebrand disease and severe COVID-19 infection. Haemophilia 2021; 27:e517-e519. [PMID: 33427345 PMCID: PMC8014028 DOI: 10.1111/hae.14252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/17/2020] [Accepted: 12/24/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Anshul Vagrecha
- Division of Hematology/Oncology and Cellular Therapy, Department of Pediatrics, Cohen Children's Medical Center, New Hyde Park, NY, USA.,Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Joseph Stanco
- Division of Hematology/Oncology and Cellular Therapy, Department of Pediatrics, Cohen Children's Medical Center, New Hyde Park, NY, USA
| | - Sumreen Majeed
- Northwell Health Cancer Institute, Imbert Cancer Center, Bay Shore, NY, USA
| | - Peter Kouides
- Mary M. Gooley Hemophilia Center, University of Rochester School of Medicine, Rochester, NY, USA
| | - Suchitra S Acharya
- Division of Hematology/Oncology and Cellular Therapy, Department of Pediatrics, Cohen Children's Medical Center, New Hyde Park, NY, USA.,Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
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Abstract
PURPOSE OF REVIEW The aim of this review is to summarize the clinical outcomes of people living with HIV (PWH) coinfected with SARS-CoV-2 during the first six months of the COVID-19 pandemic. RECENT FINDINGS Several reports from single centers have described increased, decreased, or no difference in outcomes of COVID-19 in PWH. These studies have come from a range of locations, each with different underlying HIV prevalence and access to various antiretroviral therapy (ART) regimens. Differences in healthcare quality, access and policies may also affect reported outcomes in PWH across different locations, making interpretation of results more challenging. Meanwhile, different components of ART have been proposed to protect against SARS-CoV-2 acquisition or disease progression. SUMMARY The current review considers 6 months of data across geographic regions with a range of healthcare quality and access and ART regimens to generate a wider view of COVID-19 outcomes in PWH. Taken together, these studies indicate that HIV infection may be associated with increased risk of COVID-19 diagnosis, but comorbidities appear to play a larger role than HIV-specific variables in outcomes of COVID-19 among PWH. ART does not appear to protect from COVID-19 disease acquisition, progression or death.
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Affiliation(s)
- Rowena Johnston
- amfAR, The Foundation for AIDS Research, New York, New York, USA
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12
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Pipe SW, Kaczmarek R, Srivastava A, Pierce GF, Makris M, Hermans C. Management of COVID-19-associated coagulopathy in persons with haemophilia. Haemophilia 2020; 27:41-48. [PMID: 33216448 PMCID: PMC7753457 DOI: 10.1111/hae.14191] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/21/2020] [Accepted: 10/21/2020] [Indexed: 12/12/2022]
Abstract
Introduction 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. Objective We propose practical guidance for the diagnosis and management of COVID‐19 coagulopathy in persons with haemophilia. Results 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 supported by evidence. Conclusions These practical recommendations are based on the current literature on COVID‐19 with its impact on haemostasis, indications and modalities for thromboprophylaxis mainly in nonhaemophilic patients and how that is likely to affect persons with haemophilia in different circumstances. They will need to be tailored to each patient's clinical status and validated in future studies.
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Affiliation(s)
- Steven W Pipe
- Departments of Pediatrics and Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Radoslaw Kaczmarek
- Herman B Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN, USA.,Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
| | - Alok Srivastava
- Department of Haematology, Christian Medical College, Vellore, India
| | | | - Mike Makris
- Department of Infection, Immunity and Cardiovascular disease, University of Sheffield, UK.,Sheffield Haemophilia and Thrombosis Centre, Royal Hallamshire Hospital, Sheffield, UK
| | - Cedric Hermans
- Hemostasis and Thrombosis Unit, Division of Hematology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
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- Coagulation Products Safety Supply and Access Committee of the World Federation of Hemophilia, Montreal, QC, Canada
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13
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Czajkowska S, Rupa-Matysek J, Gil L, Surdacka A. Practical Recommendations for Treatment of Dental Patients with Congenital Bleeding Disorders during the Covid-19 Pandemic: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7245. [PMID: 33023050 PMCID: PMC7579117 DOI: 10.3390/ijerph17197245] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/23/2020] [Accepted: 10/01/2020] [Indexed: 12/15/2022]
Abstract
At the end of 2019, a new disease -COVID-19-was identified, and a few months later, the World Health Organization announced a pandemic. It is now known that SARS-CoV-2 is highly contagious and most confirmed infections are mild to moderate. The situation is particularly difficult for dentists due to the high risk of virus transmission in the dental surgery. Complications including, but not limited to, problems with the respiratory and cardiovascular systems have been reported in patients with SARS-CoV-2. Several changes in the coagulation system, such as lower platelet numbers or increased prothrombin time, as well as increased D-dimer and fibrinogen, were observed. This review is intended to systematize the knowledge on the treatment of patients with congenital bleeding disorders (CBD) during the SARS-CoV-2 pandemic. Extensive literature research was conducted into COVID-19 and the general medical and dental treatment of patients with CBD. Case studies, research results and recommendations of international societies were used in the study. The results of this research are presented in the form of recommendations for the treatment of patients with coagulopathies. It should be remembered that the impact of COVID-19 on the health condition of patients with CBD is unknown to date.
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Affiliation(s)
- Sylwia Czajkowska
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Bukowska 70, 60-812 Poznan, Poland;
| | - Joanna Rupa-Matysek
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Szamarzewskiego 84, 60-569 Poznan, Poland; (J.R.-M.); (L.G.)
| | - Lidia Gil
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Szamarzewskiego 84, 60-569 Poznan, Poland; (J.R.-M.); (L.G.)
| | - Anna Surdacka
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Bukowska 70, 60-812 Poznan, Poland;
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14
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Taranchenko YL, Martinez Garcia F, Benitez-Hidalgo O, Aguilar M, Massons J, Nuñez JH. COVID-19 Infection After a Total Knee Arthroplasty in a Patient with Hemophilia A: A Case Report. JBJS Case Connect 2020; 10:e20.00537. [PMID: 37475451 DOI: 10.2106/jbjs.cc.20.00537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
CASE Minimal information is available regarding coronavirus disease-19 (COVID-19) patients with hemophilia A. Coagulopathy is a major pathophysiological characteristic of COVID-19; however, because of a paucity of data, it is not clear whether these patients with hemophilia are more or less prone to the severe form of the COVID-19 disease. We report the case of a hemophilic patient with confirmed COVID-19 after total knee arthroplasty. CONCLUSION This case highlights the idea that patients with a congenital hypocoagulability stated as haemophilia may be protected against COVID-19 hypercoagulability-related adverse effects. Thromboprophylaxis with low-molecular-weight heparin should be evaluated in patients with hemophilia and COVID-19 disease.
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Affiliation(s)
- Yuri Lara Taranchenko
- Department of Traumatology and Orthopedic Surgery, University Hospital of Vall d'Hebron, Barcelona, Spain
| | - Fernanda Martinez Garcia
- Hemophilia Unit, Department of Hematology, University Hospital of Vall d'Hebron, Barcelona, Spain
| | - Olga Benitez-Hidalgo
- Hemophilia Unit, Department of Hematology, University Hospital of Vall d'Hebron, Barcelona, Spain
| | - Marc Aguilar
- Department of Traumatology and Orthopedic Surgery, University Hospital of Vall d'Hebron, Barcelona, Spain
- Hemophilia Unit, Department of Hematology, University Hospital of Vall d'Hebron, Barcelona, Spain
| | - Josep Massons
- Department of Traumatology and Orthopedic Surgery, University Hospital of Vall d'Hebron, Barcelona, Spain
- Hemophilia Unit, Department of Hematology, University Hospital of Vall d'Hebron, Barcelona, Spain
| | - Jorge H Nuñez
- Department of Traumatology and Orthopedic Surgery, University Hospital of Vall d'Hebron, Barcelona, Spain
- Hemophilia Unit, Department of Hematology, University Hospital of Vall d'Hebron, Barcelona, Spain
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