Risk of thromboembolism in patients with COVID-19 who are using hormonal contraception

Cohen, Michael L.; Edelman, Alison; Paynter, Robin; Henderson, Jillian T.

doi:10.1002/14651858.cd014908.pub2

Cited by 6 publications

(2 citation statements)

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“…For greater detail, please see the full Cochrane Review publication. 15 Studies employing the following designs were included: randomised trials (clustered or individually randomised); quasi-experimental designs, such as non-randomised studies of interventions (NRSIs); and cohort studies with a control group. As these data are emerging, we also included non-comparative studies and case series if they had at least five cases.…”

Section: Methodsmentioning

confidence: 99%

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Risk of thromboembolism in patients with COVID-19 who are using hormonal contraception: a Cochrane systematic review

Hansen

Cohen

Ramanadhan

et al. 2023

BMJ Sex Reprod Health

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BackgroundThe coronavirus disease COVID-19 is associated with an increased risk of thrombotic events. Individuals with COVID-19 using hormonal contraception could be at additional risk for thromboembolism, but evidence is sparse.MethodsWe conducted a systematic review on the risk of thromboembolism with hormonal contraception use in women aged 15–51 years with COVID-19. We searched multiple databases through March 2022, including all studies comparing outcomes of patients with COVID-19 using or not using hormonal contraception. We applied standard risk of bias tools to evaluate studies and GRADE methodology to assess certainty of evidence. Our primary outcomes were venous and arterial thromboembolism. Secondary outcomes included hospitalisation, acute respiratory distress syndrome, intubation, and mortality.ResultsOf 2119 studies screened, three comparative non-randomised studies of interventions (NRSIs) and two case series met the inclusion criteria. All studies had serious to critical risk of bias and low study quality. Overall, there may be little to no effect of combined hormonal contraception (CHC) use on odds of mortality for COVID-19-positive patients (OR 1.0, 95% CI 0.41 to 2.4). The odds of hospitalisation for COVID-19-positive CHC users may be slightly decreased compared with non-users for patients with body mass index <35 kg/m2(OR 0.79, 95% CI 0.64 to 0.97). Use of any type of hormonal contraception may have little to no effect on hospitalisation rates for COVID-19-positive individuals (OR 0.99, 95% CI 0.68 to 1.44).ConclusionsNot enough evidence exists to draw conclusions regarding risk of thromboembolism in patients with COVID-19 using hormonal contraception. Evidence suggests there may be little to no or slightly decreased odds of hospitalisation, and little to no effect on odds of mortality for hormonal contraception users versus non-users with COVID-19.

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Section: Methodsmentioning

confidence: 99%

“…We searched the following databases from their inception to March 2022: Cochrane Central Register of Controlled Trials via EBM Reviews (Ovid), MEDLINE ALL (Ovid), Embase.com, CINAHL (EBSCOhost), LILACs, Global Health (Ovid), and Scopus. For greater detail, please see the full Cochrane Review publication 15…”

Section: Methodsmentioning

confidence: 99%