Introduction: During COVID-19 infection in hemophilic patients, several laboratory parameters associated with coagulation are affected. A significant increase in D-dimer levels is one of the main indicators of a hypercoagulable state, often related to greater disease severity and thrombotic complications. Objective: To analyze how the pathophysiology of SARS-CoV-2 infection interferes with the management of therapeutic processes in patients with hemophilia in its various forms. Methodology: This work is a bibliographic study of an exploratory-descriptive type with a qualitative approach. The literature review was conducted from 2019 to 2024. The literature search was carried out in the databases of the Virtual Health Library (VHL), PubMed, and Science Direct. The descriptors were: Hemophilia A, Hemophilia B, Blood Coagulation Disorders, and COVID-19. Results and Discussion: SARS-CoV-2 infection can worsen the clinical manifestations of hemophilia after treatment. The exacerbated inflammatory response associated with the infection, along with the formation of microthrombi, can compromise the effectiveness of standard treatment with clotting factors. In some cases, this condition may require adjustments in replacement factor dosages or the introduction of adjunct therapies such as anticoagulants, which is a challenge, as it may increase the risk of bleeding, creating a therapeutic dilemma. Conclusion: Thus, SARS-CoV-2 infection can significantly worsen coagulation in hemophilic patients, affecting both disease severity and treatment response.
