Hemorrhagic complications in patients with COVID-19. Are they unusual?

Introduction: High incidence of thromboembolic complications were described in Covid-19 patient´s studies. This favored the adoption of prophylactic measures. The recommendation was also based in the apparent absence of bleeding complications. Aim: To analyze the incidence of bleeding complications in COVID-19 disease patients who were under anticoagulation therapy. Material And Methods: Retrospective analysis of all clinical characteristics of patients with COVID-19 disease attended in our service (August-December 2020). Major and Minor Hemorrhage according to WHO grading system criteria. SPSS statistic analyze. Results: 353 patients were included. Medium age 63.32. 67.14% males. 60 died (CI: 13.44-21.27), 55 required ICU (CI:12.17-19.73). 24 patients (6.80% CI95 4.61-9.92) presented bleeding episode during admission. Major Hemorrhage in 14 (3.97% IC95 2.38-6.55) and minor clinically relevant in 10 (2.83% IC95 1.55-5.14). Thromboembolic complications were observed in 24 patients: 9 presented PE prior to admission and 13 other ones during it (3.78% CI 2.22-6.36): 3 PE, 6 DVT (catheter), 5 arterial events (1 also catheter DVT). From patients that required ICU 9 presented bleeding (16.36% 8.86-28.26), 7 of them major Hemorrhage (12.73% CI 6.30-24.02).CONCLUSIONS:The low incidence of hemorrhagic and thromboembolic complications, forces us to reconsider the convenience of maintaining the current antithrombotic prophylaxis protocols in our hospital.