Nosebleeds, medically known as epistaxis, are common and can be alarming. While not a primary or widely recognized symptom of COVID-19, connections exist between the infection and nosebleeds. Understanding these links and typical causes helps in knowing when to seek medical advice.
COVID-19 and Nosebleeds: The Connection
The virus that causes COVID-19, SARS-CoV-2, can increase the risk of nosebleeds through several mechanisms. The nasal passages are a primary entry point for the virus, as they contain ACE2 receptors that the virus uses to enter cells. This viral entry can lead to inflammation and damage within the lining and blood vessels of the nose.
Inflammation in the nasal passages, also known as rhinitis, is a common symptom of COVID-19. This inflammation can cause irritation and dryness, making the blood vessels in the nose more fragile and susceptible to breaking. Additionally, frequent coughing or sneezing, common with COVID-19, can further irritate the nasal lining and increase pressure, potentially triggering a nosebleed.
Indirect factors related to COVID-19 also contribute. Fever and dehydration can lead to dry nasal passages, increasing the likelihood of bleeding. Patients receiving supplemental oxygen therapy, particularly non-humidified oxygen delivered through a nasal cannula, may experience increased nasal dryness and irritation, which can result in nosebleeds. Furthermore, some individuals with severe COVID-19 may be prescribed anticoagulant medications, or blood thinners, to prevent blood clots. These medications reduce the blood’s ability to clot, increasing the risk of bleeding, including nosebleeds.
Understanding Nosebleeds Beyond COVID-19
Nosebleeds are common and frequently occur due to factors unrelated to COVID-19. The inside of the nose contains numerous small blood vessels that lie close to the surface, making them prone to injury and bleeding.
One frequent cause is dry air, particularly during colder months or in arid climates, which can dry out and crack the nasal membranes. Nose picking is another common cause, especially in children, as it can directly damage the nasal lining.
Other contributing factors include allergies, colds, or sinus infections, which can lead to nasal inflammation, congestion, and increased nose blowing, all irritating the nasal passages. Minor trauma to the nose, such as a bump or vigorous nose blowing, can also trigger a nosebleed. Certain medications, like some nasal sprays or aspirin, can also increase the risk.
Managing Nosebleeds and When to Seek Care
If you experience a nosebleed, there are immediate steps you can take to manage it at home. Sit down and lean slightly forward to prevent blood from flowing down the back of your throat, which can cause choking or an upset stomach. Firmly pinch the soft part of your nose, just above the nostrils, using your thumb and forefinger. Maintain continuous pressure for at least 10 to 15 minutes, breathing through your mouth.
After 10 to 15 minutes, slowly release the pressure and check if the bleeding has stopped. If it continues, pinch your nose again for another 10 to 15 minutes. Once the bleeding has stopped, avoid picking or blowing your nose, and refrain from strenuous activities for several hours to prevent dislodging any clots. Applying a cold compress to the bridge of the nose may also help.
While most nosebleeds are not serious and can be managed at home, certain situations warrant medical attention. Seek emergency care if the bleeding is heavy, does not stop after 20 minutes of continuous pressure, or if you feel weak, dizzy, or have difficulty breathing. You should also contact a healthcare provider if you experience frequent nosebleeds, are taking blood-thinning medications, or if the nosebleed followed a head injury.