The clinical course of COVID-19 in pregnant versus non-pregnant women requiring hospitalisation: results from the multicentre UK CA-COVID-19 study

Christina Crossette-Thambiah; Pip Nicolson; Indika Rajakurana; Alexander Langridge; Zara Sayar; Maria R Perelta; Sarah Essex; Roderick Oakes; Philip Mounter; Sarah Lewis; Tina Dutt; Ian Scott; Nini Aung; Susie Shapiro; Mike Laffan; Deepa RJ Arachchillage

doi:10.1111/bjh.17579

The clinical course of COVID-19 in pregnant versus non-pregnant women requiring hospitalisation: results from the multicentre UK CA-COVID-19 study

Christina Crossette-Thambiah, Pip Nicolson, Indika Rajakurana, Alexander Langridge, Zara Sayar, Maria R Perelta, Sarah Essex, Roderick Oakes, Philip Mounter, Sarah Lewis, Tina Dutt, Ian Scott, Nini Aung, Susie Shapiro, Mike Laffan, Deepa RJ Arachchillage

Cancer and Genomic Sciences

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Abstract

The impact of COVID-19 infection on pregnant women remains relatively unknown but the physiological changes of pregnancy and hypercoagulability of COVID-19 may further increase thrombotic risk. In this retrospective multicentre observational study, we report clinical characteristics and outcomes in 36 pregnant women requiring hospitalisation for COVID-19 compared to a propensity-matched cohort of non-pregnant women. Pregnant women had a lower haemoglobin and higher lymphocyte counts but no differences in other haematological or biochemical parameters on admission compared to non-pregnant women. There was no significant difference in the duration of hospitalisation; median two days (1–77) for pregnant versus eight days (1–49) for non-pregnant women. A higher proportion of non-pregnant women required mechanical ventilation [11/36 (31%) vs 3/36 (8%), P = 0·03] and received thromboprophylaxis with low-molecular-weight heparin (LMWH) within 24 h of admission [25/36 (69%) vs 15 /36(42%), P = 0·03] compared to pregnant women. One pregnant woman required extracorporeal membrane oxygenation. The rate of thrombosis was similar in both groups (one in each group). No women developed major bleeding or died. Data suggest that although non-pregnant women had a severe clinical course, overall outcomes were not different between women with or without pregnancy. The use of thromboprophylaxis was inconsistent, demonstrating a need for establishing evidence-based guidance for COVID-19 during pregnancy.

Original language	English
Pages (from-to)	85-89
Journal	British Journal of Haematology
Volume	195
Issue number	1
Early online date	16 Jun 2021
DOIs	https://doi.org/10.1111/bjh.17579
Publication status	E-pub ahead of print - 16 Jun 2021

Bibliographical note

Funding Information:
PN received research grants from Novartis, Principia and Rigel, unrestricted grants from Sanofi, Chugai and Octapharma, and honoraria from Bayer. SS has also received meeting sponsorship, speaker fees and/or consultancy from Bayer, Pfizer, NovoNordisk, Sobi, Chugai/Roche and Shire/Takeda. ML received speaker fees/consulting/advisory from Leo Pharma, Pfizer, Takeda, Sobi, Takeda, Pfizer and AstraZeneca. DJA received funding from Bayer plc to set up the multicentre database of the study as an investigator‐initiated funding and research funding from Leo Pharma. The remaining authors declare no conflicts of interest.

Publisher Copyright:
© 2021 British Society for Haematology and John Wiley & Sons Ltd

Keywords

COVID-19
bleeding
coagulopathy
pregnancy
thrombosis

ASJC Scopus subject areas

Hematology

Access to Document

10.1111/bjh.17579

Arachillage et al. COVID and pregnancy
This is the peer reviewed version of the following article:Crossette-Thambiah, C., Nicolson, P., Rajakaruna, I., Langridge, A., Sayar, Z., Perelta, M.R., Essex, S., Oakes, R., Mounter, P., Lewis, S., Dutt, T., Scott, I., Aung, N., Shapiro, S., Laffan, M. and Arachchillage, D.R.J. (2021), The clinical course of COVID-19 in pregnant versus non-pregnant women requiring hospitalisation: results from the multicentre UK CA-COVID-19 study. Br J Haematol., which has been published in final form at: https://doi.org/10.1111/bjh.17579. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
Accepted author manuscript, 791 KBLicence: Other (please specify with Rights Statement)

Cite this

Crossette-Thambiah, C., Nicolson, P., Rajakurana, I., Langridge, A., Sayar, Z., Perelta, M. R., Essex, S., Oakes, R., Mounter, P., Lewis, S., Dutt, T., Scott, I., Aung, N., Shapiro, S., Laffan, M., & Arachchillage, D. RJ. (2021). The clinical course of COVID-19 in pregnant versus non-pregnant women requiring hospitalisation: results from the multicentre UK CA-COVID-19 study. British Journal of Haematology, 195(1), 85-89. Advance online publication. https://doi.org/10.1111/bjh.17579

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abstract = "The impact of COVID-19 infection on pregnant women remains relatively unknown but the physiological changes of pregnancy and hypercoagulability of COVID-19 may further increase thrombotic risk. In this retrospective multicentre observational study, we report clinical characteristics and outcomes in 36 pregnant women requiring hospitalisation for COVID-19 compared to a propensity-matched cohort of non-pregnant women. Pregnant women had a lower haemoglobin and higher lymphocyte counts but no differences in other haematological or biochemical parameters on admission compared to non-pregnant women. There was no significant difference in the duration of hospitalisation; median two days (1–77) for pregnant versus eight days (1–49) for non-pregnant women. A higher proportion of non-pregnant women required mechanical ventilation [11/36 (31%) vs 3/36 (8%), P = 0·03] and received thromboprophylaxis with low-molecular-weight heparin (LMWH) within 24 h of admission [25/36 (69%) vs 15 /36(42%), P = 0·03] compared to pregnant women. One pregnant woman required extracorporeal membrane oxygenation. The rate of thrombosis was similar in both groups (one in each group). No women developed major bleeding or died. Data suggest that although non-pregnant women had a severe clinical course, overall outcomes were not different between women with or without pregnancy. The use of thromboprophylaxis was inconsistent, demonstrating a need for establishing evidence-based guidance for COVID-19 during pregnancy.",

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note = "Funding Information: PN received research grants from Novartis, Principia and Rigel, unrestricted grants from Sanofi, Chugai and Octapharma, and honoraria from Bayer. SS has also received meeting sponsorship, speaker fees and/or consultancy from Bayer, Pfizer, NovoNordisk, Sobi, Chugai/Roche and Shire/Takeda. ML received speaker fees/consulting/advisory from Leo Pharma, Pfizer, Takeda, Sobi, Takeda, Pfizer and AstraZeneca. DJA received funding from Bayer plc to set up the multicentre database of the study as an investigator‐initiated funding and research funding from Leo Pharma. The remaining authors declare no conflicts of interest. Publisher Copyright: {\textcopyright} 2021 British Society for Haematology and John Wiley & Sons Ltd",

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Crossette-Thambiah, C, Nicolson, P, Rajakurana, I, Langridge, A, Sayar, Z, Perelta, MR, Essex, S, Oakes, R, Mounter, P, Lewis, S, Dutt, T, Scott, I, Aung, N, Shapiro, S, Laffan, M & Arachchillage, DRJ 2021, 'The clinical course of COVID-19 in pregnant versus non-pregnant women requiring hospitalisation: results from the multicentre UK CA-COVID-19 study', British Journal of Haematology, vol. 195, no. 1, pp. 85-89. https://doi.org/10.1111/bjh.17579

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AU - Rajakurana, Indika

AU - Langridge, Alexander

AU - Sayar, Zara

AU - Perelta, Maria R

AU - Essex, Sarah

AU - Oakes, Roderick

AU - Mounter, Philip

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AU - Shapiro, Susie

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PY - 2021/6/16

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N2 - The impact of COVID-19 infection on pregnant women remains relatively unknown but the physiological changes of pregnancy and hypercoagulability of COVID-19 may further increase thrombotic risk. In this retrospective multicentre observational study, we report clinical characteristics and outcomes in 36 pregnant women requiring hospitalisation for COVID-19 compared to a propensity-matched cohort of non-pregnant women. Pregnant women had a lower haemoglobin and higher lymphocyte counts but no differences in other haematological or biochemical parameters on admission compared to non-pregnant women. There was no significant difference in the duration of hospitalisation; median two days (1–77) for pregnant versus eight days (1–49) for non-pregnant women. A higher proportion of non-pregnant women required mechanical ventilation [11/36 (31%) vs 3/36 (8%), P = 0·03] and received thromboprophylaxis with low-molecular-weight heparin (LMWH) within 24 h of admission [25/36 (69%) vs 15 /36(42%), P = 0·03] compared to pregnant women. One pregnant woman required extracorporeal membrane oxygenation. The rate of thrombosis was similar in both groups (one in each group). No women developed major bleeding or died. Data suggest that although non-pregnant women had a severe clinical course, overall outcomes were not different between women with or without pregnancy. The use of thromboprophylaxis was inconsistent, demonstrating a need for establishing evidence-based guidance for COVID-19 during pregnancy.

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The clinical course of COVID-19 in pregnant versus non-pregnant women requiring hospitalisation: results from the multicentre UK CA-COVID-19 study

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

Access to Document

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Cite this