Impact of COVID-19 pandemic on the joint bleeding pattern and prophylactic management of hemophilia patients: A single centre study in a tertiary care centre of Eastern India

Background : Patients with hemophilia if not treated adequately can lead to permanent joint disease. The global pandemic SARS COVID 19 had many consequences in the management of hemophilia patients which are of great concern, especially in developing countries like India. Aims : This study aims to assess the impact of COVID 19 pandemic on the joint bleeding pattern and prophylactic management of hemophilia patients. Methods : A longitudinal study was done on 32 boys of age ranging from 4 to 18 years attending the Hemophilia day care centre of Pediatrics department of Midnapore Medical College and Hospital from March 2020 to October 2020. Results : Knee joint was predominantly affected by hemarthrosis followed by elbow joint, ankle joint and shoulder joint. Out of total, 90.62% patients had developed target joints. Knee joint was the predominant target joint in 59.37% cases. No significant change in the joint bleeding pattern was observed before and after COVID 19. Annualised bleeding rate was found to be worsened during the pandemic which was statistically significant (P value < 0.0001). Seventy eight percent patients had more than 4 weeks of absenteeism from taking prophylactic factor therapy during the pandemic. The reason for being absent was due to non-availability of transport in 60% cases, non-availability of factor in 24% cases and financial reasons in 12% cases. Conclusions : Joint bleeding episodes worsened during the COVID 19 pandemic. Hemophilic patients and their families faced a lot of challenges during this period in getting the prophylactic factor therapy mainly due to non-availability of transport and also due to nonavailability of factor and financial reasons in few cases.