Long-term impact of COVID-19 on haemophilia: a multicenter study in Southwest China.

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic is not yet over as millions of people are still diagnosed with persistent symptoms of COVID-19 (long COVID) worldwide. Despite some advances in haemophilia research, the precise relationship between COVID-19 and haemophilia remains elusive, warranting further investigation.

Methods: A total of 254 cases of people with haemophilia (PwH) infected with COVID-19 from Southwest China were enrolled in the present study. Baseline characteristics, clinical manifestations, treatment methods, and vaccination data were collected and analyzed. Patients were followed up for clinical characteristics at 1, 2, 4, and 16 weeks and 6 months after COVID-19. The spontaneous bleeding characteristics, joint functional status (assessed by the Haemophilia Joint Health Score [HJHS] and Haemophilic Early Arthropathy Detection with Ultrasound [HEAD-US]), coagulation factor inhibitors formation, characteristics of long COVID and changes in mental state were analyzed.

Results: The clinical features of the 254 PwH were analyzed in the study. A significant reduction in spontaneous bleeding frequency was observed in all body regions except the gingiva during COVID-19 (p < 0.05). This pattern of reduced bleeding during infection, followed by an increase post-infection, was observed across the cohort, which included patients with varying severities of haemophilia (severe, n = 167; moderate, n = 59; mild, n = 28). In addition, PwH developed long COVID, characterized by chronic cough (7.87%) and fatigue (5.12%). Six months after COVID-19 infection, approximately 13.39% of PwH showed anxiety and the number of patients with moderate depression and extremely severe depression increased significantly (p < 0.05). During the six-month follow-up, no significant alterations in coagulation factor activity or joint functional status were observed among PwH. A comparison of joint functional status before and after COVID-19 infection revealed no significant difference in the HJHS, with scores of 21.79 ± 15.79 vs 23.81 ± 14.96 (p > 0.05). The HEAD-US Score was 20.33 ± 11.93 vs 20.62 ± 12.61, p > 0.05. In addition, one patient developed coagulation factor Ⅷ inhibitors after COVID-19 infection.

Conclusions: This study indicates that spontaneous bleeding episodes are decreased among PwH during COVID-19 infection, and the infection does not cause deterioration of joint function. In addition, it underscores the necessity of close monitoring of long COVID-related impacts as well as COVID-19-associated mental health conditions in PwH.

Clinical trial number: Not applicable.