June 20, 2024

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Why It Happens and What to Do

During a COVID infection, people might experience other health conditions or complications. One minor condition that can happen is a nosebleed, medically known as epistaxis. Nosebleeds aren’t a symptom of COVID, but situations related to COVID—like the effect of treatments on a person’s nose—can cause epistaxis.

There’s limited research about how common COVID-related nosebleeds are overall in larger groups. However, researchers identified the prevalence of epistaxis in smaller studies. For example, one study found that six out of 40 individuals (15%) with nosebleeds had COVID compared to one out of 40 in the control group. Read on to learn more about COVID and having a bloody nose, including treatment and when to see a healthcare provider.

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Some studies have pointed to a correlation between nosebleeds and COVID. They’ve indicated that nosebleeds may result from what COVID or its treatments do to the mucous membranes rather than a clear symptom.

In one study, 30 patients with COVID developed nosebleeds while hospitalized. The participants required oxygen therapy—a nosebleed risk factor—administered through continuous airway pressure or a nasal cannula, a thin tube. Also, the patients in the study were taking anticoagulant (anti-clotting) drugs, another contributing factor for nosebleeds.

Another procedure commonly used in diagnosing and treating COVID has entailed swabbing the nose. Researchers documented evidence of nosebleeds following the procedure, indicating a need for careful swabbing—particularly in older patients.

Research has indicated that having a bloody nose is possible following vaccination. Some participants in one study reported that their noses bled after COVID vaccination. However, the percentages were small:

  • 0.3% of participants reported a nosebleed after the first dose of an mRNA vaccine
  • 0.5% of participants reported a nosebleed after the second dose of an mRNA vaccine
  • 2.1% of participants reported a nosebleed after an adenovirus-vectored vaccine

COVID can cause other nasal symptoms like nasal congestion or a runny nose. A COVID infection may also result in smell disorders, such as:

  • Anosmia: omplete loss of smell
  • Hyposmia: Partial loss of smell
  • Parosmia: Distorted sense of smell where pleasant things can smell unpleasant
  • Phantosmia: Distorted sense of smell where a person smells something without the stimulus it belongs to

Nosebleeds can happen for several reasons, such as:

  • Blowing or picking your nose
  • Cold or dry air
  • Decongestant nasal spray overuse
  • Deviated septum tissue
  • Drugs or medicines that are sprayed or snorted
  • Irritation from allergies, colds, sinus problems, or sneezing
  • Nasal-based oxygen treatments
  • Nose injuries
  • Sinus surgery

Take the following steps to treat a bloody nose:

  1. Gently squeeze the soft part of your nose with your thumb and index finger for at least five minutes while sitting down.
  2. Lean forward during that time, and don’t pack your nose with gauze.
  3. Check if you still have any bleeding after five minutes. If so, repeat for up to 10 minutes until the bleeding has stopped.

Using cold compresses on or icing the bridge of your nose can be helpful. Once the bleeding has stopped, try not to blow your nose or sniff.

There are a few ways to reduce your risk of having a bloody nose, which include:

  • Avoiding hard nose-blowing
  • Keeping your noise moist
  • Not picking your nose
  • Using a humidifier if you have dry air in your home environment

Consult a healthcare provider about nosebleeds that are frequent, occur with an unknown cause, or happen after surgeries. Seek emergency medical care if you have COVID warning signs or for the following concerning nosebleeds:

  • Continuous bleeding after 20 minutes
  • History of nosebleeds requiring specialized treatment
  • Nosebleeds following a head injury or while taking blood thinners
  • A potential broken nose

It’s possible for nosebleeds related to COVID or COVID vaccinations to occur, but they are not a symptom of the illness. COVID causes other nasal symptoms like a runny nose or smell disorders, while a bloody nose may result from dry air or nose injuries or irritation.

You can treat and reduce the likelihood of having a bloody nose. However, see a healthcare provider if you have concerns or complications related to a bloody nose or COVID.

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