Abstract Number: PB0187
Meeting: ISTH 2021 Congress
Background: Coronavirus disease 2019 (COVID-19) occurs following infection with the highly transmissible, and potentially fatal, severe-acute-respiratory-syndrome-coronavirus-2 (SARS-CoV-2) virus. Infection can be complicated by coagulopathy featuring abnormal coagulation parameters, thrombo-inflammation, and thrombocytopenia, collectively termed COVID-19 associated coagulopathy (CAC). Data concerning CAC prevalence and management in pregnancy is limited. Evaluation of physician experiences in assessing and managing CAC is essential to identify current practice patterns and knowledge gaps.
Aims: To determine physician experiences and practice patterns relevant to CAC prevention and management in pregnancy.
Methods: A cross-sectional study with self-administered online questionnaire using the RedCap online platform; supported by the ISTH Subcommittee on Women’s Health Issues in Thrombosis and Hemostasis.
Results: Of 115 physicians who opened the survey, 74 (38% Maternal-Fetal Medicine, 31% Haematology/Thrombosis) provided responses conducive to analysis. There were 1503 reported cases of COVID-19, from which 1288 contained data regarding disease severity. Sixty-five percent of COVID-19 infections were mild while only 4% were severe. Of all reported cases, 1% developed CAC, of which 63% were in the severe spectrum of COVID-19 infection. The most frequently identified abnormalities included thrombocytopenia, elevated CRP, D-dimer, and lymphopenia. Low-molecular-weight heparin was the anticoagulant of choice, provided by 67% of respondents, with 56% using standard-prophylactic dosing for CAC. Thrombosis occurred in 6 patients on anticoagulation; 50% were receiving standard prophylactic dosing, while the remaining 50% were unspecified. Anticoagulation duration depended on disease severity and additional thrombosis risk factors.
Conclusions: CAC is uncommon in pregnancy with a predilection for higher disease severity. Anticoagulation practices vary and may not reflect current guideline recommendations. Development of thrombosis has been observed in CAC on standard prophylactic anticoagulation, thus emphasizing the need for re-evaluation of anticoagulant regime in severe cases. Urgent research is required to determine appropriate anticoagulant dosing and duration in these patients.
To cite this abstract in AMA style:Jevtic S, Malinowski AK, Othman M, Abdul Kadir R. Physicians’ Knowledge and Management Practices of COVID-19 Coagulopathies in Pregnancy [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/physicians-knowledge-and-management-practices-of-covid-19-coagulopathies-in-pregnancy/. Accessed October 1, 2023.
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