The other side of coagulation complications in COVID-19: a case report of two major bleeding events

A. Karels-Van Den Berg, J. Rutgers*, H. Endeman, E. de Jongh, M. J.H.A. Kruip

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)


Coronavirus disease 2019 (COVID-19) is still an ongoing pandemic and has already resulted in millions of deaths worldwide. Since it is frequently associated with thrombotic complications, most hospitalised patients receive some form of anticoagulant therapy. Lately, bleeding events in patients with COVID-19 have also been increasingly reported. It is not yet clear whether these are also part of the spectrum of coagulation dysfunction in COVID-19. We report two cases of patients with COVID-19 with a large spontaneous haemorrhage during therapeutic anticoagulant therapy, after a long-term stay in the ICU. We propose several hypotheses for the occurrence of bleeding in COVID-19. Physicians should be aware of this risk, especially when patients are being treated with anticoagulants, because changes in the patient’s condition during the course of the disease could lead to a relative overdose. We advise regular reassessment of anticoagulation dosage in patients with COVID-19.

Original languageEnglish
Pages (from-to)14-18
Number of pages5
JournalNetherlands Journal of Critical Care
Issue number1
Publication statusPublished - Jan 2022

Bibliographical note

Funding Information:
Informed consent for publication of this case report (and the accompanying images) was obtained from the patient’s next of kin (case A) and the patient (case B). All authors declare no conflict of interest. No funding or financial support was received.

Publisher Copyright:
© 2022, Netherlands Society of Intensive Care. All rights reserved.


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