Post-COVID Factor X Deficiency: A Case Report From Pakistan

Acquired Factor X deficiency is a rare hematological disease, characterized by excessive bleeding, with fewer than 50 cases reported in the literature and practically all being associated with amyloidosis. We describe a case of a 38-year-old man with no known family history of hematologic disorders who had symptoms of a mild COVID-19 infection. Upon resolution, he developed excessive bleeding features, including epistaxis and hematuria. It was later found that while the rest of the coagulation factors were within normal limits, Factor X was 7% of the normal value, which reversed about two months after recovery. Our case highlights the significance of the less-expected post-COVID bleeding complications, in contrast to the classically seen thrombotic ones.