Report of the ISTH registry on pregnancy and COVID-19-associated coagulopathy (COV-PREG-COAG).

Background: Concerns about COVID-19-associated coagulopathy (CAC) in pregnant individuals were raised in early pandemic. Methods: An ISTH-sponsored COVID-19 coagulopathy in pregnancy (COV-PREG-COAG) international registry was developed to describe incidence of coagulopathy, VTE, and anticoagulation in this group. Results: All pregnant patients with COVID-19 from participating centers were entered, providing 430 pregnancies for the first pandemic wave. Isolated abnormal coagulation parameters were seen in 20%; more often with moderate/severe disease than asymptomatic/mild disease (49% vs 15%; p < 0.0001). No one met the ISTH criteria for disseminated intravascular coagulopathy (DIC), though 5/21 (24%) met the pregnancy DIC score. There was no difference in antepartum hemorrhage (APH) with asymptomatic/mild disease versus moderate/severe disease (3.4% vs 7.7%; p = 0.135). More individuals with moderate/severe disease experienced postpartum hemorrhage (PPH) (22.4% vs 9.3%; p = 0.006). There were no arterial thrombotic events. Only one COVID-associated venous thromboembolism (VTE) was reported. Conclusions: Low rates of coagulopathy, bleeding, and thrombosis were observed among pregnant people in the first pandemic wave.

Optimising educational opportunities for trainees during the pandemic.

Trainees around the world have experienced significant challenges to their personal life and training as a result of the COVID-19 pandemic. Many have felt the psychological and physical impacts of working during the COVID-19 pandemic. Training-specific challenges have included redeployment, cancellation of operative lists, cancellation of educational opportunities and loss of exposure to training as a result of shielding. This article describes the impact of infection with COVID-19 on psychological wellbeing and training. It discusses general measures the trainee can take to mitigate the challenges this has caused, categorised into personal, planning and educational resources, and measures focussed on certain challenges. Finally, the vital importance of support for trainees is described, including peer support, departmental resources and the growing array of online material.