This case discusses the challenges created by COVID-19 (coronavirus disease 2019) in the area of hormonal contraception, highlighting the contraception knowledge gap for women in their post COVID-19 period, especially if they had high D-dimer levels. This case involves a thirty-eight-year-old woman taking combined oral contraception (desogestrel/ethinyl oestradiol tablets) with a history of varicose veins. She recovered from a COVID-19 infection in November 2020. She presented to the emergency room with right lower-limb pain below the knee and progressive swelling for five days in February 2021. Physical examination of the lower limb showed mild swelling and tenderness of the right leg compared to the left leg. D-Dimer was elevated (1.06 mcg/mL FEU). COVID-19 screening was negative. A Doppler scan to exclude DVT was performed considering the clinical picture and high D-dimer level. There was no evidence of DVT in the right limb. She was reassured and discharged with instructions on when to visit the emergency room. The D-dimer had decreased to 0.53 mcg/mL FEU in March 2021. She booked an appointment with family medicine clinics because she was concerned about the continuation of combined oral contraception (desogestrel/ethinyl oestradiol tablets) with high D-dimer and risk of thrombosis. The follow-up D-dimer level in May 2021 was normal (0.4 mcg/mL FEU). The patient preferred to continue taking oral contraception. An evidence-based consensus is needed to guide clinicians in providing contraception counselling for such patients.

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COVID-19 后 D-二聚体升高的口服复方避孕药使用者：病例报告

本案例讨论了 COVID-19（2019 冠状病毒病）在激素避孕领域带来的挑战，强调了女性在 COVID-19 后时期的避孕知识差距，特别是如果她们的 D-二聚体水平较高。本病例为一名三十八岁女性，服用复方口服避孕药（去氧孕烯/炔雌醇片），有静脉曲张病史。她于 2020 年 11 月从 COVID-19 感染中康复。2021 年 2 月，她因膝盖以下右下肢疼痛和进行性肿胀而入急诊室，持续五天。下肢体检显示下肢轻度肿胀和压痛。右腿与左腿相比。D-二聚体升高（1.06 mcg/mL FEU）。COVID-19 筛查结果为阴性。考虑到临床表现和高 D-二聚体水平，进行了多普勒扫描以排除 DVT。右肢没有 DVT 证据。她得到了关于何时去急诊室的指示，这让她放心并出院。2021 年 3 月，D-二聚体已降至 0.53 mcg/mL FEU。她预约了家庭医学诊所，因为她担心继续服用 D-二聚体较高的复方口服避孕药（去氧孕烯/乙炔雌二醇片）和风险血栓形成。2021 年 5 月的随访 D-二聚体水平正常（0.4 mcg/mL FEU）。患者倾向于继续服用口服避孕药。需要基于证据的共识来指导临床医生为此类患者提供避孕咨询。