Low absolute risk of thrombotic and cardiovascular events in outpatient pregnant women with COVID-19

• DOI: 10.1016/j.thromres.2024.02.021
• Publication Date: 2024-04-06T17:49:02Z
• Authors: Behnood Bikdeli; Darsiya Krishnath...; Candrika D. Khairani; Antoine Bejjani; Julia Davies; Nicole Porio; Anthony Tristani; Andre Armero; Ali A. Assi; Victor Nauffal; Umberto Campia; Zaid Almarzooq; Eric Wei; Marcos D. Ortiz-Rios; Valeria Zuluaga-S...; Aditya Achanta; Sirus J. Jesudasen; Bruce Tiu; Geno J. Merli; Orly Leiva; John Fanikos; Elvira Grandone; Aditya Sharma; Samantha Rizzo; Mariana B. Pfeferman; Ruth B. Morrison; Alec Vishnevsky; Judith Hsia; Mark R. Nehler; James Welker; Marc P. Bonaca; Brett Carroll; Samuel Z. Goldhaber; Zhou Lan; Gregory Piazza
• Keywords: Adult; Male; Cardiology; 610; Cardiovascular event; male; Pregnancy; Risk Factors; middle aged; 616; Outpatients; risk factors; Humans; Registries; Pregnancy Complications, Infectious; humans; thrombosis; Venous Thrombosis; 000; pregnancy complications; SARS-CoV-2; adult; Incidence; registries; Outpatient; COVID-19; Thrombosis; Middle Aged; outpatients; cardiovascular diseases; infectious; female; Virus Diseases; Cardiovascular Diseases; incidence; Female; pregnancy; venous thrombosis; Female Urogenital Diseases and Pregnancy Complications; Venous thromboembolism

Pregnancy may contribute to an excess risk of thrombotic or cardiovascular events. COVID-19 increases the risk of these events, although the risk is relatively limited among outpatients. We sought to determine whether outpatient pregnant women with COVID-19 are at a high risk for cardiovascular or thrombotic events.We analyzed pregnant outpatients with COVID-19 from the multicenter CORONA-VTE-Network registry. The main study outcomes were a composite of adjudicated venous or arterial thrombotic events, and a composite of adjudicated cardiovascular events. Events were assessed 90 days after the COVID-19 diagnosis and reported for non-pregnant women ≤45 years, and for men ≤45 years, as points of reference.Among 6585 outpatients, 169 were pregnant at diagnosis. By 90-day follow-up, two pregnant women during the third trimester had lower extremity venous thrombosis, one deep and one superficial vein thrombosis. The cumulative incidence of thrombotic events was 1.20 % (95 % confidence interval [CI]: 0.0 to 2.84 %). Respective rates were 0.47 % (95 % CI: 0.14 % to 0.79 %) among non-pregnant women, and 0.49 % (95 % CI: 0.06 % to 0.91 %) among men ≤45 years. No non-thrombotic cardiovascular events occurred in pregnant women. The rates of cardiovascular events were 0.53 % (95 % CI: 0.18 to 0.87) among non-pregnant women, and 0.68 % (95 % CI: 0.18 to 1.18) in men aged ≤45 years.Thrombotic and cardiovascular events are rare among outpatients with COVID-19. Although a higher event rate among outpatient pregnant women cannot be excluded, the absolute event rates are low and do not warrant population-wide cardiovascular interventions to optimize outcomes.