Coagulation

COVID-19 associated coagulopathy low in pregnancy: ISTH registry 


Thrombotic events in pregnant women with COVID-19 are reassuringly low, new registry data reveals.

Initial findings from the COV-PREG-COAG registry were presented to the ISTH 2021 virtual congress taking place this week.

From 426 COVID-19 affected pregnancies, over 75% of  infections occurred in the third trimester and 56% of women were asymptomatic. Overall, 11% were hospitalised, 9% had severe disease, and 2% required ICU admission.

Obesity and advanced maternal age and being part of an ethnic minority group were associated with severe COVID-19 infection.

“The most common symptoms, which were in keeping with findings from other studies, were cough, fever, shortness of breath and anosmia,” said lead researcher and haematologist Dr Sajida Kazi from Newcastle Upon Tyne NHS Trust, UK.

The figures showed a  live birth rate of 98.3% and preterm deliveries affecting pregnancies were around 13%.

COVID associated coagulopathy features included prolonged PT (53%), thrombocytopenia (4.9%), and hyperfibrinogenemia (11%). D-dimer was available in 20 pregnancies and was elevated in 65% of these.

“We did see one venous thromboembolic event and this occurred in a pregnancy associated with severe Covid-19 despite appropriate thromboprophylaxis” Dr Kazi noted.

“Overall though, the thrombotic events were quite low despite pregnancy itself being a state of hypercoagulability and this was surprising for us,” she said.

Within the cohort bleeding rates were low, with pre- and post- partum rates of around 4% and 7% respectively.

The registry will remain open for  worldwide healthcare providers to continue entering data about pregnancies and COVID-19 infection, Dr Kazi told Congress.

“The COVID-19 pandemic is evolving and we continue to get more information about the haematological complications associated with COVID-19 infection and the same stands with pregnancy,” she said.

“The marker specific parameters of thrombosis and haemostasis will continue to give us more information specifically about  the prognostic value of predicting the severity of COVID-19 infection and predicting the outcomes of the pregnancies,” she added.

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