ABSTRACT
Infection due to Sars-CoV-2 is known to present with a wide range of signs and symptoms, ranging from mild symptoms [1] to severe respiratory ill-ness and inflammatory response, systemic dysfunctions even until death [2]. However, coagulation-related abnormalities are also observed. So far, the scientific community has focused attention on hypercoagula-bility state causing thromboembolic events [3]. A tendency to bleed has been far less frequently investigated. Often, this tendency is referred to minor bleeding and seems to be explained by an immune thrombocyto-penia [4]. In our clinical experience, however, a remarkably increasing number of cases of dysfunctional uterine bleeding has been observed in adolescents with ongoing or previous Sars-CoV-2 infection. As a consequence, in some cases a severe anaemia has been registered. We report the case of a patient with severe anaemia associated with a sudden dysfunctional uterine bleeding started out after a Sars-CoV-2 in-fection. In our case, haemoglobin level was lower than 8 mg/dl (i.e., se-vere anaemia [5]) and the patient had to be treated with tranexamic acid, with a slow progressive decrease of bleeding. Other cases have been rec-orded, before realising of a likely association between bleeding and Sars-Covid infection. Currently, a database has been created to study coagulation and hormo-nal status of the adolescents showing this clinical pattern. The aim is to explore possible relations between the bleeding condition and the Sars-CoV-2 infection and, eventually, to explain this clinical framework. A multicentre trial involving international teams is going to be set up as far as to obtain more data, to have a clearer definition and to possibly confirm the suspicion of a correlation.