ISTH Registry on Pregnancy and COVID-19 Associated Coagulopathy (COV-PREG-COAG)- First Report
Sajida Kazi, M.B.B.S.
Newcastle upon Tyne NHS Trust
Newcastle upon Tyne, U.K.
The ISTH Scientific and Standardization Committee for Women’s Health Issues in Thrombosis and Hemostasis developed the International Registry on Pregnancy and COVID-19 Associated Coagulopathy (COV-PREG-COAG) addressing COVID-19 associated coagulopathy (CAC) in pregnancy. Why is this of importance? Increased susceptibility to severe illnesses has been reported in the pregnant population, following infection with SARS‐CoV‐2 resulting in COVID-19. In the nonpregnant population, 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 remain scarce. Results from this worldwide study were presented by Sajida Kazi of Newcastle NHS Foundation Trust, Newcastle upon Tyne, U.K., on Monday, July 19, 2021, which looked at pregnancy demographics, disease state, comorbidities, hemostatic parameters, details of coagulopathy and its treatment, as well as fetal and maternal outcomes. Based on the 426 COVID-19 affected pregnancies reported, over 75% of COVID-19 occurred in the third trimester and 56% of women were asymptomatic. The most common symptoms included cough (51%), fever (50%), shortness of breath (20%), and anosmia (13%). Comorbid pathologies were reported as follows: obesity (60%), respiratory illnesses (7%), and diabetes (2%). Among 336 women with complete information, 11% were hospitalized, 9% had severe disease, and 2% required ICU admission. CAC 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. A total of 66% of women received postpartum thromboprophylaxis. There was one venous thromboembolic event and no maternal deaths. Kazi commented that the ISTH registry demonstrates that CAC and thrombotic events are infrequent in COVID-19 affected pregnancies. Further data are required before drawing definite conclusions.