Abstract Number: OC 33.1
Meeting: ISTH 2021 Congress
Background: Increased susceptibility to severe illnesses has been reported in pregnancy, following infection with SARS‐CoV‐2 resulting in COVID-19, in part evoked by pregnancy-related physiologic and immunologic changes. In the non-pregnant population, COVID-19 associated coagulopathy (CAC) with a thrombotic phenotype has been described in those with severe illness. Pregnancy is an inherently prothrombotic state, yet data on CAC in pregnancy remains scarce. The ISTH SSC for Women’s Health Issues in Thrombosis and Haemostasis developed the international registry (COV-PREG-COAG) addressing CAC in pregnancy.
Aims: To examine the occurrence of CAC during pregnancy, its characteristics, association with disease severity, and effects on maternal and fetal outcomes.
Methods: Physicians worldwide were invited to participate. The ISTH REDCap online platform, which utilizes robust data confidentiality and security protocols for data capture, was adopted. Data included: pregnancy demographics, disease state, comorbidities, haemostatic parameters, details of coagulopathy and its treatment, as well as fetal and maternal outcomes. As of March 8, 2021, 340 COVID-19 affected pregnancies were reported to COV-PREG-COAG.
Results: Table 1 summarizes relevant findings. Over 80% of COVID-19 occurred in the third trimester and 55% of women were asymptomatic. Most common symptoms included cough (47%), fever (39%), shortness of breath (25%) and anosmia (17%). Comorbid pathologies were reported as follows: obesity (66%), respiratory illnesses (7.6%) and diabetes (2.4%). Among 336 women with complete information, 5% were hospitalized, 3.3% had severe disease, and 1.3% required ICU admission. Two patients with CAC required ECMO/mechanical ventilation. CAC features included: prolonged PT/APTT (9.1%), thrombocytopenia (4.9%), elevated D-dimer (4.6%), hyper-fibrinogenemia (5%). Non of the patients developed hypofibrinogenemia. Sixty-six percent of women received postpartum thromboprophylaxis. There was one venous thromboembolic event and no maternal deaths.
|COVID-19 Disease Severity and Comorbid Pathologies||N||Denominator||Percentage|
|COVID-19 Associated Coagulopathy||N||Denominator||Percentage|
|APTT indicates activated partial thromboplastin time; BMI, body mass index; COVID-19, coronavirus disease 2019; DM, diabetes mellitus; ECMO, extracorporeal membrane oxygenation; ICU, intensive care unit; PT, partial thromboplastin; VTE, venous thromboembolism.|
Conclusions: This early report from the ISTH registry demonstrates that CAC and thrombotic events are infrequent in COVID-19 affected pregnancies. Further data is required before drawing definite conclusions.
To cite this abstract in AMA style:Kazi S, Othman M, Khoury R, Bernstein P, Thachil J, Ciantar E, Netto M, Ferrara L, Abdul-Kadir R, Malinowski A. ISTH Registry on Pregnancy and COVID-19 Associated Coagulopathy (COV-PREG-COAG) – First Report [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 1). https://abstracts.isth.org/abstract/isth-registry-on-pregnancy-and-covid-19-associated-coagulopathy-cov-preg-coag-first-report/. Accessed September 16, 2021.
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