Thrombotic Markers in Pregnant Patients with and without SARS-CoV-2 Infection

Ann M Bruno1,2, Amanda A Allshouse1, Ashley E Benson3

  • 1Department of Obstetrics & Gynecology, University of Utah Health, Salt Lake City, Utah.

PubMed

Insights

COVID-19 in pregnant individuals did not alter D-dimer levels or increase thrombosis risk. However, higher than expected rates of lupus anticoagulant (LAC) positivity were observed in SARS-CoV-2 infected pregnancies.

Area of Science:

  • Obstetrics and Gynecology
  • Infectious Diseases
  • Hematology

Background:

  • Coronavirus disease 2019 (COVID-19) is linked to coagulation issues and a higher risk of blood clots.
  • Pregnant individuals with Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may face unique thrombotic risks.

Purpose of the Study:

  • To investigate D-dimer levels and lupus anticoagulant (LAC) positivity in pregnant individuals with and without SARS-CoV-2 infection.
  • To compare thrombotic markers between infected and non-infected pregnant individuals, considering disease severity.

Main Methods:

  • A prospective cohort study included pregnant individuals delivering between April 2020 and March 2022.
  • SARS-CoV-2 positive individuals were compared to a control group; D-dimer and LAC positivity were assessed at delivery.
  • Thromboembolic events and disease severity were secondary outcomes.

Main Results:

  • No significant difference in D-dimer levels was found between SARS-CoV-2 positive and negative pregnant individuals.
  • A higher rate of LAC positivity was observed in the SARS-CoV-2 positive group (4%) compared to the negative group (0%), though not statistically significant.
  • No clinically apparent thromboses occurred in either group, and D-dimer or LAC positivity did not correlate with COVID-19 severity.

Conclusions:

  • SARS-CoV-2 infection in pregnancy did not significantly alter D-dimer levels or increase the incidence of thromboembolic events.
  • Elevated rates of LAC positivity were noted in pregnant individuals with SARS-CoV-2 infection, warranting further investigation.
  • Despite altered coagulation markers, clinically significant thrombosis was not observed in this cohort.
Abstract

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