Women who are pregnant or taking estrogen with birth control or hormone replacement therapy may be at high risk.
COVID-19 may increase the risk of transfer clots in pregnant or estrogen-taking women with contraception or hormone replacement therapy, according to a new manuscript published in the Endocrine Society journal, Endocrinology.
One of the many complications of COVID-19 is the formation of blood clots in previously healthy people. Estrogen increases the chance of blood clots during pregnancy and in women taking birth control pills or hormone replacement therapy. If infected with COVID-19, the risk of blood clotting for these women may be even higher, and they may need to undergo anticoagulation therapy or discontinue their estrogen medications.
“During this pandemic, we need additional research to determine whether women who become infected with the coronavirus during pregnancy should receive anticoagulation therapy or whether women taking birth control pills or hormone replacement therapy should discontinue them,” said the study’s corresponding author. , Daniel I. Spratt, MD, from the Maine Medical Center in Portland, Maine, and from Tufts University School of Medicine in Boston, Massachusetts. “Research that helps us understand how the coronavirus causes blood clots may also provide us with new insights into how blood clots form in other settings and how to prevent them.”
Investigating and understanding the cause of blood clotting in COVID-19, including the effects of estrogen therapy or pregnancy, has several obstacles and will require innovative animal and tissue models.
Conversations between basic physicians and researchers and between endocrinologists and hematologists are necessary to explore possible interactions between SARS-CoV-2 – the virus that causes COVID-19 – and pregnancy or estrogen therapy that could guide clinical management.
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Reference: “COVID-19 and hypercoagulability: potential impact in the management with oral contraceptives, estrogen therapy and pregnancy” July 29, 2020, Endocrinology.
The manuscript is co-authored by Rachel J. Buchsbaum, MD, of Tufts Medical Center and Tufts University School of Medicine.
