Understanding the Management of Acute Spontaneous Bleeding in Patients with COVID-19

Introduction: COVID-19 infection has an impact on patient's coagulation status. In particular the increased risk of thromboembolism means patients are on anticoagulation medication. We identified an increased incidence of acute spontaneous bleeding in this subset of patients and studied this topic.

Method(s): Retrospective review of all patients treated with endovascular embolization for acute spontaneous bleeding with active COVID-19 during the 2-year period of the pandemic. Data related to patient demographics, anticoagulation status, site of bleeding, procedure details, need for re-intervention and 1 month follow-up were collected. A total of 15 patients fitted the criteria for the study. Analysis was performed on SPSS.

Result(s): A total of 15 cases of acute spontaneous bleeding treated with endovascular embolization with active COVID-19 were identified. In addition, 11/15 patients were receiving anticoagulation medication. The most common location of bleeding was the lumbar arteries 9/15. A mortality rate of 46% was observed at 30 days in this group of patients.

Conclusion(s): In this subset of patients, aggressive management of spontaneous bleeding with a combination of coils and gel-foam is required. Despite successful embolization the mortality rate is high.

Publication History

Article published online:
09 February 2023