ABSTRACT
Subcutaneous injections are recommended instead of intramuscular for patients with bleeding disorders to avoid bleeding complications. This study aimed to determine whether the intramuscular administration of COVID-19 vaccines would increase bleeding-associated complications in patients with bleeding disorders followed in our clinic. We collected the data of 47 patients with bleeding disorders older than 18 years followed at the hematology outpatient clinic and screened between March 15, 2020, and December 31, 2021. We obtained the data from the hospital's electronic information system, including age, gender, type of bleeding disorder, factor levels, and whether they received prophylaxis. We interviewed the participants about the type of vaccine they received and the duration of compression they applied to the injection site, whether they received factor replacement before and after the injection, and whether there were any complications following the injection. We included in the study thirty-nine male patients vaccinated against COVID-19. The mean age of the patients was 39.05 (18-73 years). Factor VIII deficiency constituted 79.4%, XI 10.3%, and other bleeding disorders 10.3 % of the cases. The patients with bleeding disorders had a mean factor level of 2.02 (0-9). Twenty-nine (74.4%) patients were on regular factor prophylaxis for their bleeding disorder. In terms of the compression duration to the injection site following injection, 6 (15.4%) patients had applied compression for 10 min, 4 (10.3%) for 5-10 min, and 29 (73.4%) for less than 5 min. Two (5.1%) patients developed ecchymosis after the first vaccine dose on the injection arm. The results of this study demonstrate that the rate of bleeding complications remains low in patients with bleeding disorders if they receive intramuscular vaccination after necessary precautions. Copyright © 2022 Ondokuz Mayis Universitesi. All rights reserved.
ABSTRACT
Hematology patients are extremely vulnerable to COVID-19 infection due to the immunosuppression arising from the direct effect of the disease and the medicines administered. Our purpose is to analyze the results of the patients that both have a hematological disease and receive treatment for COVID-19 infection in our hospital. Four hundred COVID-19 positive patients that received inpatient treatment between March 12, 2020 and October 1, 2020 in our center and got a diagnosis by using real -time polymerase chain reaction (RT-PCR) test were scanned retrospectively. Eighty one patients were included in the study. Nineteen patients had a hematological disease;62 had a chronic disease but didn't have a hematological disease. We found that the group with hematological disease had a high level of ferritin (p= 0.0001). While the use of steroids in COVID-19 treatments is more frequent in the group with hematological disease (p= 0.01), the use of LMWH (low molecular weight heparin) is more frequent in the group with no hematological diseases (p= 0.02). Intensive care treatment and mechanical ventilatory support were required more for the patients with hematological disease than the others (p= 0.03. p= 0.008). While the mortality rate is 42.1% in the patients with hematological disease, it is 9.7% in the patients with chronic disease (p= 0.003). In cox regression analysis, the study found that hematological diseases (HR: 4.02, 95% CI: 1.7-1844.5, p= 0.02), cardiac diseases (HR: 2.28, 95% CI: 1.2-77.9, p= 0.03), and intensive care treatment (HR: 4.60, 95% CI: 3.1-3115.0, p= 0.009) are significant risk factors. Hematological patients infected with COVID-19 have a more severe and mortal clinical manifestation than the patients with other chronical disease.