The severe-acute-respiratory-syndrome-coronavirus-2 (SARS-CoV-2) virus infection causes the coronavirus disease 2019 (COVID-19). COVID-19 is often seen with thrombosis, thrombocytopenia, and other coagulation abnormalities. COVID-19 associated coagulopathy (CAC) is defined by the occurrence of such coagulation abnormalities that further complicate the disease. Presently, limited data related to CAC in pregnancy and its management is available.
The management of CAC during pregnancy and the overall experience of the physicians was to be documented and presented by this study.
The International Society on Thrombosis and Hemostasis (ISTH) subcommittee on women's health issues in thrombosis and hemostasis supported a self-administered survey on the RedCap online platform to collect data.
The survey was completed partially or entirely by about 75 respondents. 1,298 specified the severity of the disease out of the total 1546 reported cases.
Only 4% of cases were severe, and 64% were cases of mild infection.
CAC was noted in only 1% of the cases, and 65% of these CAC cases were severe.
Elevated CRP, D-dimer, thrombocytopenia, and lymphopenia were the most frequent CAC-related abnormalities.
77% of respondents managed CAC using low molecular weight heparin as the anticoagulant of choice. Standard prophylactic dosing of low molecular weight heparin was used by around 60% of these physicians.
The incidence of thrombosis was encountered in 7 anticoagulated patients who were being given weight-based or standard prophylactic dosing.
The duration of anticoagulant therapy required depended on thrombosis risk factors and the severity of COVID-19 disease.
The survey reported that in pregnant women with COVID-19 infection, CAC remains rare. The prescription of anticoagulation therapy was observed to vary, and physicians may not follow the current guidelines in all the cases. Some patients with CAC exhibited incidence of CAC, despite being given weight-adjusted and standard dosing of prophylactic anticoagulants. The rapid and extensive spread of COVID-19 calls for urgent research to establish the optimal duration and dosing of anticoagulants in pregnant women.