Congenital Bleeding Disorders amid the COVID-19 pandemic: Open questions and recommendations

Main Article Content

Majid Naderi
Fatemeh Malek
Ghasem Miri Aliabad
Mahammad Behnampoor
Mehran Karimi
Vincenzo De Sanctis


COVID-19, congenital bleeding disorders, treatment, surveillance


This article reviews the current knowledges of congenital bleeding disorders (CBD) amid the COVID-19 pandemic. It appears that CBD is not associated with higher risk of getting COVID-19 and so the prevalence of COVID-19 among them seems not higher compared to the general population. In absence of specific therapeutic recommendations, it is essential to make a correct assessment of the risk of haemorrhage/thrombosis. Based on expert opinion, strategies for outpatient management include adherence to prescribed regimens, telemedicine, and communication about COVID-19 in patients with CBD. More data should be also collected to better characterize the impact of COVID-19 on patients with CBD. The current findings encourage further studies to determine the prevalence of SARS-CoV2 infection in CBD patients to understand more fully the burden of this novel pathogen and to develop adequate preventive measures against this infection.


Download data is not yet available.
Abstract 904 | PDF Downloads 529


1. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention [published online ahead of print, 2020 Feb 24]. JAMA. 2020;10.1001/ jama.2020. 2648. doi:10.1001/jama.2020.2648.
2. Leebeek FW, Eikenboom JC. Von Willebrand’s Disease. N Engl J Med. 2017;376:701-702.

3. Montgomery RR, Flood VH. What have we learned from large population studies of von Willebrand disease? Hematol Am Soc Hematol Educ Program. 2016; 2016:670-677.

4. Bowman ML, James PD. Controversies in the diagnosis of type 1 von Willebrand disease. Int J Lab Hematol. 2017;39 (Suppl 1):61-68.

5. Castaman G, Linari S. Diagnosis and treatment of von Willebrand disease and rare bleeding disorders. Clin Med. 2017;6: E45. doi: 10.3390/jcm6040045.

6. Montgomery RR, Flood VH. What have we learned from large population studies of von Willebrand disease? Hematol Am Soc Hematol Educ Program. 2016; 2016:670-677.

7. Neff AT. Current controversies in the diagnosis and management of von Willebrand disease. Ther Adv Hematol. 2015; 6:209-216.

8. Mahlangu JN, Gilham A. Guideline for haemophilia treatment in South Africa. S Afr Med J.
2008; 98:126-140.

9. Gresele P. Subcommittee on Platelet Physiology of the International Society on Thrombosis and
Hemostasis. Diagnosis of inherited platelet function disorders: Guidance from the SSC of the ISTH.
J Thromb Haemost. 2015; 13:314-322.

10. Kenny D, Mezzano D, Mumford AD, et al. Diagnosis of suspected inherited platelet function disorders: Results of a worldwide survey. J Thromb Haemost. 2014; 12:1562-1592.

11. Hayward CP, Rao AK, Cattaneo M. Congenital platelet disorders: Overview of their mechanisms,
diagnostic evaluation and treatment. Haemophilia. 2006; 12:128-136.

12. Dorgalaleh A, Dabbagh A, Tabibian S, et al. Patients with Congenital Bleeding Disorders Appear to be Less Severely Affected by SARS-CoV-2: Is Inherited Hypocoagulability Overcoming Acquired Hypercoagulability of Coronavirus Disease 2019 (COVID-19)? Semin Thromb Hemost. 2020;10.1055/s-0040-1713435.

13. Álvarez Román MT, Butta Coll N, García Barcenilla S, et al. Registry of patients with congenital bleeding and COVID-19 in Madrid. [published online ahead of print, 2020 Jun 10]. Haemophilia. 2020;10.1111/ hae.14089. doi:10.1111/hae.14089.

14. Thachil J, Tang N, Gando S, et al. ISTH interim guidance on recognition and management
of coagulopathy in COVID-19. J Thromb Haemost. 2020 March 25. doi:10.1111/jth.14810

15. Chen G, Wu D, Guo W, et al. Clinical and immunologic features in severe and moderate coronavirus disease 2019. J Clin Invest. 2020; 130:2620-2629.

16. Han H, Yang L, Liu R, et al. Prominent changes in blood coagulation of patients with SARS-CoV-2 infection. Clin Chem Lab Med. 2020; 58:1116–1120.

17. Xiong M, Liang X, Wei YD. Changes in blood coagulation in patients with severe coronavirus disease 2019 (COVID-19): a meta-analysis. Br J Haematol. 2020; 189:1050–1063.

18. Coppola A, Tagliaferri A, Rivolta GF, Quintavalle G, Franchini M. Confronting COVID-19: Issues in Hemophilia and Congenital Bleeding Disorders. Semin Thromb Hemost. 2020 Jun. DOI: 10.1055/s-0040-1712961.

19. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet (London, England). 2020; 395:497-506.

20. Cui S, Chen S, Li X, Liu S, Wang F. Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia. J Thromb Haemost. 2020. [Epub ahead of print] . Doi: 10.1111/jth.14830.

21. Klok FA, Kruip MJHA, van der Meer NJM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res. 2020; S0049-3848(20)30120-1; [Epub ahead of print] . Doi: 10.1016/j.thromres.2020.04.013.

22. Dolhnikoff M, Duarte-Neto AN, de Almeida Monteiro RA, et al. Pathological evidence of pulmonary thrombotic phenomena in severe COVID-19. J Thromb Haemost. 2020. [Epub ahead of print]. Doi: 10.1111/jth.14844.

23. Bikdeli B, Madhavan MV, Jimenez D, et al. COVID-19 and thrombotic or thromboembolic disease: implications for prevention, antithrombotic therapy, and follow-up. J Am Coll Cardiol 2020; S0735-1097(20)35008-7. doi: 10.1016/j. jacc.2020.04.031.

24. Cui D, Zhang A, Liu A, Hu Q. Clinical findings in a patient with haemophilia A affected by COVID-19. Haemophilia 2020. [Epub ahead of print] . Doi: 10.1111/hae.14000

25. World Federation of Haemophilia. Specific risks of COVID-19 to the bleeding disorders community. Available at https://news.
Accessed April 28, 2020.

26. Hemophilia, WFO. Specific Risks of COVID-19 to the Bleeding Disorders Community April 2, 2020: World Federation of Hemophilia 2020 [Available from
27. Kulkarni R. Use of telehealth in the delivery of comprehensive care for patients with haemophilia and other inherited bleeding disorders. Haemophilia. 2018; 24: 33‐42.

28. Hermans C, Lambert C, Sogorb A, Wittebole X, Belkhir L, Yombi JC. In-hospital management of persons with haemophilia and COVID-19: practical guidance [published online ahead of print, 2020 May 8]. Haemophilia. 2020;10.1111/hae.14045. doi:10.1111/hae.14045


30. Mannucci PM. Hemophilia therapy: the future has begun. Haematologica. 2020; 105:545-553.

31. Bangalore S, Sharma A, Slotwiner A, et al. ST-Segment Elevation in Patients with Covid-19 - A Case Series. N Engl J Med. 2020; 382:2478-2480.

32. Tang N, Bai H, Chen X, Gong J, Li D, Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost. 2020; 18:1094-1099.

33. World Federation of Haemophilia. Specific risks of COVID-19 to the bleeding disorders community. Available at
Accessed April 28, 2020.

34. Wichmann D, Sperhake JP, Lütgehetmann M, et al. Autopsy Findings and Venous Thromboembolism in Patients With COVID-19 [published online ahead of print, 2020 May 6]. Ann Intern Med. 2020; M20-2003. doi:10.7326/M20-2003.

Most read articles by the same author(s)

<< < 1 2 3 4 5 6 7 8 9 10 > >>