Increasing evidence suggests that COVID-19 can cause blood clots, and the risk for those complications may be increased among people who are pregnant or who take estrogen-containing medicine (including some kinds of birth control). So researchers are warning that we need to learn a lot more about how these two factors could converge with potentially lethal results.

In a recent article, published last month in Endocrinology, the two authors lay out the emerging connection between COVID-19 and blood clotsand call for more research into how the coronavirus might impact those who are already at risk for developing blood clots.

People who already are at an increased risk for blood clots and the complications associated with them (such as pulmonary embolism, deep venous thromboembolism, and strokes) include those who are pregnant, those who are taking hormonal birth control, and those on oral estrogen therapy (hormone replacement therapy). So, the authors write, its worth examining whether or not people in those groups who also get COVID-19 are at an especially high risk for blood clots and health issues related to them.

To be clear, there are currently no reports of increased cases of COVID-related blood clots among those who are pregnant, on birth control pills, or taking estrogen therapy, co-author Daniel Spratt, M.D., director of reproductive endocrinology and infertility at Maine Medical Center and professor of Medicine and Obstetrics-Gynecology at Tufts University School of Medicine, tells SELF. However, its definitely plausible those two things in combination would increase your risk, Taraneh Shirazian, M.D., gynecologist at NYU Langone Health, tells SELF, because both being in one of those elevated-risk groups and having COVID-19 individually increase the risk.

However, were still learning quite a bit about how COVID-19 affects the body, including how it might contribute to blood clots. [Were] realizing that were just at the beginning of getting information and understanding if theres a risk or not, Dr. Spratt says.

What we do know is that the association between COVID-19 and blood clots is there, especially among young and otherwise healthy patients, Dr. Spratt says. In general, age and underlying health conditions tend to be some of the most powerful risk factors for severe complications of COVID-19, but that doesnt seem to be the case for coronavirus-related blood clots.

We also dont yet know why or how the infection causes blood clots. There are essentially two major theories right now, Dr. Spratt says, and its likely that both may be at work to different degrees in different patients. According to one theory, the virus responsible for COVID-19 affects the lining of the arteries and veins, setting off a series of molecular signals that make clotting more likely. The second theory has more to do with platelets, a type of blood cell thats involved in clotting. It appears that the coronavirus somehow makes platelets hyperreactive, possibly causing them to clot more frequently.

We also know that theres an association between the hormone estrogen and blood clots, Dr. Shirazian says. In particular, people who are pregnant, taking birth control pills, or taking estrogen therapy are known to be at a higher risk for developing blood clots, she explains. We know a little bit more about why people in these groups may be more likely to experience clots.

During pregnancy, there are physical changes taking place that simply make it more likely for blood to coagulate (a hypercoagulable state, as its known in medical literature). A pregnant person has a 50% increase in blood volume, Dr. Shirazian explains, but also has a significant slowing of blood flow. That creates a situation where theres slowing of the blood and these clots can start [to form] inside of blood vessels, she says.

More here:
What People Taking Birth Control Should Know About COVID-19 and Blood Clots - Self

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