COVID

May 5, 2022

COVID-associated bleeding risk

While case reports have noted acquired hemophilia after COVID-19 infection or vaccination, a new study finds no increased risk.

Recent case reports have noted acquired coagulation factor inhibitors in patients with SARS-CoV-2 infection or after vaccination. Coagulation factor inhibitors are autoantibodies that can disrupt any step in the blood clotting cascade and increase bleeding risk.  

Allison Wheeler, MD, MSCI, and colleagues characterized the incidence and clinical findings of coagulation factor inhibitors in patients with COVID-19 and vaccine recipients. The researchers conducted a comprehensive literature review and analysis of data from the Centers for Disease Control and Prevention’s Vaccine Adverse Event Reporting System. 

They report in Research and Practice in Thrombosis and Haemostasis that the incidence of coagulation factor inhibitors in patients with SARS-CoV-2 infection or vaccination (1.2 cases per 10 million doses) is rare and appears similar to the general population. 

Given the use of heparin in patients hospitalized with COVID-19 (a pro-thrombotic risk factor), it is important for clinicians to be aware of the potential for acquired coagulation factor inhibitors, the researchers conclude.

Joining Wheeler on the study were Shannon Walker, MD, and Garrett Booth, MD, MS, at VUMC, Jeremy Jacobs, MD, MHS, at Yale School of Medicine, and Brian Adkins, MD, at University of Texas Southwestern Medical Center.