COVID-19, caused by the SARS-CoV-2 virus, affects various bodily systems. While fever, cough, and fatigue are common symptoms, some wonder if nosebleeds are connected. Nosebleeds are not a primary or common symptom of COVID-19, but indirect associations or contributing factors can lead to them during or after an infection.
Understanding the Connection
COVID-19 can increase the likelihood of nosebleeds through several indirect mechanisms. The virus often enters through nasal passages, which have delicate blood vessels and fragile tissue. Viral presence can cause inflammation (rhinitis) and direct damage to these tissues, making blood vessels more susceptible to bleeding. This inflammation often leads to congestion and a runny nose, further irritating and drying the nasal lining, increasing nosebleed risk.
General illness symptoms associated with COVID-19 can also play a role in nosebleeds. Fever and dehydration, common during viral infections, can contribute to dryness of the nasal membranes. Frequent or forceful nose blowing and coughing, often done to clear respiratory passages, can exert pressure and cause trauma to the delicate nasal capillaries, triggering a bleed. Patients receiving oxygen therapy, particularly through nasal cannulas, may also experience increased nasal dryness and tissue injury, which can lead to nosebleeds.
Certain over-the-counter medications commonly used to manage cold and flu symptoms during a COVID-19 infection might also contribute to nosebleeds. Decongestant nasal sprays, when overused, can dry out the nasal membranes, making them more prone to bleeding. While non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are generally considered safe for pain and fever relief during COVID-19, some blood-thinning medications can increase bleeding risk.
Environmental conditions can exacerbate nasal dryness, particularly when someone is resting indoors for extended periods during recovery. Low humidity, often found in heated indoor spaces, causes the nasal membrane to dry out, become crusty, or crack. This dryness makes the delicate tissue more vulnerable to bleeding from minor irritation or even normal air movement through the nose. Some research suggests a direct viral impact on blood vessels or coagulation, but this is less commonly cited as a direct cause for nosebleeds compared to the indirect factors.
Immediate Steps for a Nosebleed
If a nosebleed occurs, remaining calm is the first step, as nervousness can sometimes worsen bleeding. Sit upright and lean slightly forward to prevent blood from draining down the back of the throat. Swallowing blood can cause nausea, vomiting, or choking.
Gently pinch the soft part of the nose, just above the nostrils, using your thumb and index finger. Apply continuous pressure for about 10 to 15 minutes, breathing through your mouth during this time. This direct pressure helps to compress the bleeding blood vessels, allowing a clot to form.
Avoid releasing the pressure to check if the bleeding has stopped before the full 10 to 15 minutes have passed. After the bleeding has ceased, refrain from picking, rubbing, or blowing your nose immediately to prevent dislodging the newly formed clot. It is also advisable to avoid strenuous activity, heavy lifting, or bending over for several hours after a nosebleed.
When to Seek Medical Attention
While most nosebleeds are not serious and can be managed at home, certain situations warrant medical evaluation, especially if they occur in the context of a COVID-19 infection. Seek immediate medical attention if the nosebleed lasts longer than 20 minutes, even after applying continuous pressure. This duration indicates that the bleeding may be more significant than a typical nosebleed.
Professional medical advice is recommended if:
The amount of blood lost is substantial, such as enough to fill a cup, or if the bleeding is very heavy.
Difficulty breathing, feeling faint, or dizziness accompanies the nosebleed.
The nosebleed resulted from a head injury or facial trauma.
Nosebleeds are recurring, even if individually minor.