Incidence of venous thromboembolism in women on HRT/COC and who get Covid.
Dear Editor,
Thromboembolic events are a recognised sequel to Corona virus infection and come under the syndrome of "long covid." They require ongoing anti-coagulation and monitoring. I have seen young women with documented pulmonary emboli who were also taking the oral contraceptive pill. A recent editorial in Endocrinology reported no publication of any such events but did highlight the possibility of increased hypercoagulability with this combination.[1] The combined oral contraceptive is associated with a 2 to 6 fold increase in venous thromboembolic events (VTE).[2] Corona virus is associated with up to 30% incidence of VTE.[3]
A database of VTE in women who get infected with Corona virus and who are also taking any oestrogen progestogen preparation should be compiled with a view to risk guidance in the present pandemic climate. The data for VTE in women taking iatrogenic hormones (COC, HRT) and who contract Corona virus infection have not been published to date.
1 COVID-19 and Hypercoagulability: Potential Impact on Management with Oral Contraceptives, Estrogen Therapy and Pregnancy.Daniel I Spratt, Rachel J Buchsbaum. Endocrinology, Volume 161, Issue 12, December 2020, bqaa121, https://doi.org/10.1210/endocr/bqaa121.
2. Stegeman BH, de Bastos M, Rosendaal FR, et al. Different combined oral contraceptives and the risk of venous thrombosis: systematic review and network meta-analysis. BMJ. 2013;347:f5298.
3 Thromboembolism risk of COVID-19 is high and associated with a higher risk of mortality: A systematic review and meta-analysis. Mahmoud B. Malas1, Isaac N. Naazie1, Nadin Elsayed, Asma Mathlouthi, Rebecca Marmor,Bryan Clary. https://doi.org/10.1016/j.eclinm.2020.100639
Competing interests:
No competing interests
11 February 2021
Eugene Breen
Psychiatrist, Associate Clinical Professor
Mater Misericordiae University Hospital Dublin, University College Dublin
Rapid Response:
Incidence of venous thromboembolism in women on HRT/COC and who get Covid.
Dear Editor,
Thromboembolic events are a recognised sequel to Corona virus infection and come under the syndrome of "long covid." They require ongoing anti-coagulation and monitoring. I have seen young women with documented pulmonary emboli who were also taking the oral contraceptive pill. A recent editorial in Endocrinology reported no publication of any such events but did highlight the possibility of increased hypercoagulability with this combination.[1] The combined oral contraceptive is associated with a 2 to 6 fold increase in venous thromboembolic events (VTE).[2] Corona virus is associated with up to 30% incidence of VTE.[3]
A database of VTE in women who get infected with Corona virus and who are also taking any oestrogen progestogen preparation should be compiled with a view to risk guidance in the present pandemic climate. The data for VTE in women taking iatrogenic hormones (COC, HRT) and who contract Corona virus infection have not been published to date.
1 COVID-19 and Hypercoagulability: Potential Impact on Management with Oral Contraceptives, Estrogen Therapy and Pregnancy.Daniel I Spratt, Rachel J Buchsbaum. Endocrinology, Volume 161, Issue 12, December 2020, bqaa121, https://doi.org/10.1210/endocr/bqaa121.
2. Stegeman BH, de Bastos M, Rosendaal FR, et al. Different combined oral contraceptives and the risk of venous thrombosis: systematic review and network meta-analysis. BMJ. 2013;347:f5298.
3 Thromboembolism risk of COVID-19 is high and associated with a higher risk of mortality: A systematic review and meta-analysis. Mahmoud B. Malas1, Isaac N. Naazie1, Nadin Elsayed, Asma Mathlouthi, Rebecca Marmor,Bryan Clary. https://doi.org/10.1016/j.eclinm.2020.100639
Competing interests: No competing interests