Thromboprophylaxis in a patient with COVID-19 and severe hemophilia A on emicizumab prophylaxis.
J Thromb Haemost
; 18(9): 2202-2204, 2020 09.
Article
in English
| MEDLINE | ID: covidwho-593310
ABSTRACT
COVID-19 can be associated with coagulopathy (CAC, COVID-19-associated coagulopathy) with a high prothrombotic risk based on an intense inflammatory response to viral infection leading to immunothrombosis through different procoagulant pathways. Emerging evidence suggests that the use of heparin in these patients could be associated with lower mortality. Emicizumab is a bispecific humanized monoclonal antibody that bridges activated factor IX and factor X, thereby restoring the function of missing factor VIIIa in hemophilia A. The use of emicizumab has been associated with thrombotic events in patients who also received high cumulative amounts of activated prothrombin complex concentrates. Although this risk is extremely low, there is a lack of evidence on whether CAC increases the thrombotic risk in patients on emicizumab prophylaxis. We present the case of a patient with severe hemophilia A in prophylaxis treatment with emicizumab; due to the potential thrombotic risk we decided to administer low molecular weight heparin as prophylaxis treatment without any thrombotic or bleeding complications.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Antibodies, Bispecific
/
Venous Thromboembolism
/
Antibodies, Monoclonal, Humanized
/
COVID-19
/
Hemophilia A
Type of study:
Case report
/
Cohort study
/
Observational study
/
Prognostic study
Topics:
Long Covid
Limits:
Humans
/
Male
/
Middle aged
Language:
English
Journal:
J Thromb Haemost
Journal subject:
Hematology
Year:
2020
Document Type:
Article
Affiliation country:
Jth.14954
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