In a fight against the novel coronavirus, researchers have revealed that COVID-19 may increase the risk of blot clots in women who are pregnant or taking estrogen with birth control or hormone replacement therapy.
According to the researchers, the novel coronavirus, SARS-CoV-2, has proven unusual with respect to the spectrum of its pathological effects. "In addition to the damage inflicted on the lungs, kidneys, heart and other organ systems, reports have emerged of hypercoagulable states in patients hospitalized with COVID-19," said study author Daniel I. Spratt from the Tufts University in the US.
Role of Estrogen
A hypercoagulable state is a medical term for a condition in which there is an abnormally increased tendency toward blood clotting (coagulation). According to a new manuscript published in the Endocrine Society's 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, these women's risk of blood clotting could be even higher, and they may need to undergo anticoagulation therapy or to discontinue their estrogen medicines.
"During this pandemic, we need additional research to determine if women who become infected with the coronavirus during pregnancy should receive anticoagulation therapy," Spratt said. "Or if women taking birth control pills or hormone replacement therapy should discontinue them. Research that helps us understand how the coronavirus causes blood clots may also provide us with new knowledge regarding how blood clots form in other settings and how to prevent."
Hurdles That Require Innovative Models
Researching and understanding the cause of blood clotting in COVID-19, including the intersecting effects of estrogen therapy or pregnancy, has several hurdles and will require innovative animal and tissue models, the team said.
Conversations between clinicians and basic researchers and between endocrinologists and hematologists are necessary to explore potential interactions between COVID-19 and pregnancy or estrogen therapy that could guide clinical management.