Table 1.

Patients with recorded bleeding within 90 days of admission

Age, yComorbidityHb, g/LPlatelets, × 109/LPT, sAPTT, sAntiplatelet/anticoagulant medication at time of bleedLevel of careVTEDays from admission to bleedISTH bleed severityTransfusionDetails
80 CKD 69 138 10.9 25.6 Prophylactic LMWH Ward  19 Major 2 units RBC and 2 units FFP UGI bleed with hemorrhagic gastritis and benign duodenal ulcer 
61 HTN, CVA 130 167 10.5 21.2 Aspirin + prophylactic LMWH Ward  0 CRNMB  Epistaxis on admission; topical treatment with phenylephrine 
89 HTN, malignancy 85 197 49.4  Warfarin Ward  4 CRNMB  Epistaxis with high INR; warfarin stopped 
80 HTN, asthma 124 142   Apixaban Ward  4 CRNMB  UGI bleed; apixaban stopped 
97 HTN, PVD 152 234   Prophylactic LMWH Ward  4 CRNMB  Calf hematoma following trauma 
72 COPD, CVA 154 281   Clopidogrel + prophylactic LMWH Ward  18 CRNMB  UGI bleed 
57 Nil 98 343 12.7 35.2 Prophylactic LMWH ICU DVT 15 Major  SAH on CT scan of the head; investigating low GCS on reducing sedation 
72 Asthma, malignancy (DLBCL), CKD 59 94 11.6 22.3 Apixaban Ward PE (segmental) 0 Major 11 units RBCs Diverticular bleed after starting apixaban for AF, life-threatening, managed medically; no embolization or surgery 
82 Malignancy (myeloma) 82 16 10.5 34.7 Nil Ward  7 CRNMB 1 unit platelets Epistaxis; low platelets secondary to myeloma 
57 Malignancy (AML) 119 24   Nil Ward  3 CRNMB 1 unit platelets Epistaxis; low platelets secondary to AML 
82 HTN, DM 173 111 12.6 22 Apixaban Ward  0 CRNMB  UGI bleed on admission; apixaban held 
79 CKD 104 112 13.9 43 Therapeutic LMWH Ward  3 CRNMB  UGI bleed; treatment dose dalteparin recently given for suspected PE 
94 IHD, CVA 101 299 11.4 33.1 Apixaban Ward  13 CRNMB  UGI bleed; stopped apixaban 
77* Progressive supranuclear palsy     Apixaban Ward  79 CRNMB  Epistaxis in community after starting apixaban for AF; apixaban stopped 
81* HTN, COPD, IHD, VTE 65 211 11.2 22 Apixaban Ward  41 Major 5 units RBCs UGI bleeds secondary to angiodysplasia of stomach 
Age, yComorbidityHb, g/LPlatelets, × 109/LPT, sAPTT, sAntiplatelet/anticoagulant medication at time of bleedLevel of careVTEDays from admission to bleedISTH bleed severityTransfusionDetails
80 CKD 69 138 10.9 25.6 Prophylactic LMWH Ward  19 Major 2 units RBC and 2 units FFP UGI bleed with hemorrhagic gastritis and benign duodenal ulcer 
61 HTN, CVA 130 167 10.5 21.2 Aspirin + prophylactic LMWH Ward  0 CRNMB  Epistaxis on admission; topical treatment with phenylephrine 
89 HTN, malignancy 85 197 49.4  Warfarin Ward  4 CRNMB  Epistaxis with high INR; warfarin stopped 
80 HTN, asthma 124 142   Apixaban Ward  4 CRNMB  UGI bleed; apixaban stopped 
97 HTN, PVD 152 234   Prophylactic LMWH Ward  4 CRNMB  Calf hematoma following trauma 
72 COPD, CVA 154 281   Clopidogrel + prophylactic LMWH Ward  18 CRNMB  UGI bleed 
57 Nil 98 343 12.7 35.2 Prophylactic LMWH ICU DVT 15 Major  SAH on CT scan of the head; investigating low GCS on reducing sedation 
72 Asthma, malignancy (DLBCL), CKD 59 94 11.6 22.3 Apixaban Ward PE (segmental) 0 Major 11 units RBCs Diverticular bleed after starting apixaban for AF, life-threatening, managed medically; no embolization or surgery 
82 Malignancy (myeloma) 82 16 10.5 34.7 Nil Ward  7 CRNMB 1 unit platelets Epistaxis; low platelets secondary to myeloma 
57 Malignancy (AML) 119 24   Nil Ward  3 CRNMB 1 unit platelets Epistaxis; low platelets secondary to AML 
82 HTN, DM 173 111 12.6 22 Apixaban Ward  0 CRNMB  UGI bleed on admission; apixaban held 
79 CKD 104 112 13.9 43 Therapeutic LMWH Ward  3 CRNMB  UGI bleed; treatment dose dalteparin recently given for suspected PE 
94 IHD, CVA 101 299 11.4 33.1 Apixaban Ward  13 CRNMB  UGI bleed; stopped apixaban 
77* Progressive supranuclear palsy     Apixaban Ward  79 CRNMB  Epistaxis in community after starting apixaban for AF; apixaban stopped 
81* HTN, COPD, IHD, VTE 65 211 11.2 22 Apixaban Ward  41 Major 5 units RBCs UGI bleeds secondary to angiodysplasia of stomach 

AF, atrial fibrillation; AML, acute myeloblastic leukemia; CKD, chronic kidney disease; COPD, chronic obstructive pulmonary disease; CT, computed tomography; CVA, cerebrovascular accident; DLBCL, diffuse large B-cell lymphoma; DM, diabetes mellitus; FFP, fresh frozen plasma; GCS, Glasgow coma score; HTN, hypertension; IHD, ischemic heart disease; INR, international normalized ratio; PVD, peripheral vascular disease; SAH, subarachnoid hemorrhage; UGI, upper gastrointestinal.

*

Denotes patients who developed bleeding after discharge from index admission with COVID-19 infection. ISTH bleeding definitions: MB is fatal bleeding, bleeding into a critical organ, bleeding causing more than 20 g/L decrease in hemoglobin (Hb), or transfusion of 2 or more units of red blood cells (RBCs); CRNMB is bleeding that does not meet major criteria but requires medical intervention or hospitalization. Blood tests presented were taken within 24 hours of the bleed (data missing for 1 patient). Results outside the normal range are bolded. Normal ranges: Hb, 120-150 g/L; platelet count, 150-400 × 109/L; prothrombin time (PT) (Siemens Innovin, Sysmex CS5100) 9-12 seconds; activated partial thromboplastin time (APTT) (Siemens Actin FS, Sysmex CS5100) 20-30 seconds.

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