Here, we describe 12 patients exhibiting RPH/RSH complications whilst admitted for management of COVID-19 infection and evaluate the importance of this specific bleeding complication and the implications for management. Keywords: COVID-19; hematoma; heparin; low molecular weight EN COVID-19 hematoma heparin low molecular weight 923 927 5 09/02/21 20210901 NES 210901 High rates of venous thromboembolism (VTE) have been observed in Coronavirus 2019 disease (COVID-19).1 Regulatory bodies in the UK advise pharmacological VTE prophylaxis with standard prophylactic low-molecular-weight heparin (LMWH) dosing, escalating to a therapeutic dose if there is a high clinical suspicion of VTE.2 Furthermore, in December 2020, an interim analysis of pooled data from the ACTIV-4a, REMAPCAP and ATTACC randomised clinical trials suggested that LMWH was beneficial for patients not requiring intensive care support.3 However, there is growing awareness of the bleeding risk associated with COVID-19.4 The interim analysis of the afore-mentioned clinical trials paused enrolment of critically ill patients due to futility and a potential for harm due to higher rates of bleeding in these patients.3 Additionally, a systematic review of incidence of VTE and bleeding amongst hospitalised patients with COVID-19 found that pooled incidence was 17% for VTE, 7-1% for pulmonary embolism (PE), 7-8% for bleeding and 3-9% for major bleeding. Both patients showed immediate post-procedure haemodynamic stabilisation, however, one developed a myocardial infarction secondary to hypoperfusion during the bleed and the other developed urinary tract obstruction due to the size of the haematoma. [Extracted from the article]