Other underlying conditions such as heart disease, diabetes or asthma can contribute to risks.

Published: January 12, 2022

Some pediatric patients with bleeding disorders may have a higher risk of severe illness from COVID-19, especially if they have serious underlying medical conditions such as heart disease, diabetes, obesity or asthma.

Although most bleeding disorders are not associated with impaired immunity, COVID-19 can be a concern for children who are taking immune-suppressing medications, as is sometimes the case with pediatric patients with bleeding disorders.

Bleeding disorders affect the body’s blood-clotting process. They can cause a patient either to bleed or clot too easily, depending on the diagnosis. There are many kinds of bleeding disorders, including hemophilia, anemia, von Willebrand disease and sickle cell disease.

Symptoms of bleeding disorders can include easy, frequent bruising and excessive bleeding after minor injuries.

More recently diagnosed pediatric bleeding disorder patients may be most at risk

Medication to treat some bleeding disorders can trigger an immune response — called an “inhibitor” — in the patient’s body to fight off the treatment. This is most commonly seen in patients with hemophilia A, hemophilia B, and von Willebrand disease Type 3.

One way to counteract the inhibitor response is with immunosuppressant medications that leave the patient more vulnerable if infected with viruses such as the one that causes COVID-19.

According to Kerry K. McGowan, M.D., pediatric hematologist/oncologist with Norton Children’s Cancer Institute, affiliated with the UofL School of Medicine, inhibitors can appear at any age, but they are more likely to appear in younger children who are within the first 50 days of their treatment.

That may be why hematologists at Norton Children’s Cancer Institute have been seeing patients recently diagnosed with bleeding disorders being affected by the virus more so than kids who’ve been undergoing treatment longer, according to Dr. McGowan.

COVID-19 vaccines especially important for pediatric patients with bleeding disorders

Eligible children, especially those with bleeding disorders, should get a COVID-19 vaccine.

“The vaccine gives extra protection to pediatric patients with bleeding disorders,” Dr. McGowan said. “Health care providers can follow special protocols while giving the shot to these patients, including the use of the finest-gauge needles.”

Many children with blood disorders are born with the disease, and children under 5 years old are not yet eligible for a COVID-19 vaccine. Families can take proactive steps to protect their child’s health by ensuring that everyone in the household who is eligible is fully vaccinated against COVID-19.