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American Society of Hematology 2021 guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19.


ABSTRACT:

Background

Coronavirus disease 2019 (COVID-19)-related critical illness and acute illness are associated with a risk of venous thromboembolism (VTE).

Objective

These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in decisions about the use of anticoagulation for thromboprophylaxis for patients with COVID-19-related critical illness and acute illness who do not have confirmed or suspected VTE.

Methods

ASH formed a multidisciplinary guideline panel and applied strict management strategies to minimize potential bias from conflicts of interest. The panel included 3 patient representatives. The McMaster University GRADE Centre supported the guideline-development process, including performing systematic evidence reviews (up to 19 August 2020). The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The panel used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, including GRADE Evidence-to-Decision frameworks, to assess evidence and make recommendations, which were subject to public comment.

Results

The panel agreed on 2 recommendations. The panel issued conditional recommendations in favor of prophylactic-intensity anticoagulation over intermediate-intensity or therapeutic-intensity anticoagulation for patients with COVID-19-related critical illness or acute illness who do not have confirmed or suspected VTE.

Conclusions

These recommendations were based on very low certainty in the evidence, underscoring the need for high-quality, randomized controlled trials comparing different intensities of anticoagulation. They will be updated using a living recommendation approach as new evidence becomes available.

SUBMITTER: Cuker A 

PROVIDER: S-EPMC7869684 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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American Society of Hematology 2021 guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19.

Cuker Adam A   Tseng Eric K EK   Nieuwlaat Robby R   Angchaisuksiri Pantep P   Blair Clifton C   Dane Kathryn K   Davila Jennifer J   DeSancho Maria T MT   Diuguid David D   Griffin Daniel O DO   Kahn Susan R SR   Klok Frederikus A FA   Lee Alfred Ian AI   Neumann Ignacio I   Pai Ashok A   Pai Menaka M   Righini Marc M   Sanfilippo Kristen M KM   Siegal Deborah D   Skara Mike M   Touri Kamshad K   Akl Elie A EA   Bou Akl Imad I   Boulos Mary M   Brignardello-Petersen Romina R   Charide Rana R   Chan Matthew M   Dearness Karin K   Darzi Andrea J AJ   Kolb Philipp P   Colunga-Lozano Luis E LE   Mansour Razan R   Morgano Gian Paolo GP   Morsi Rami Z RZ   Noori Atefeh A   Piggott Thomas T   Qiu Yuan Y   Roldan Yetiani Y   Schünemann Finn F   Stevens Adrienne A   Solo Karla K   Ventresca Matthew M   Wiercioch Wojtek W   Mustafa Reem A RA   Schünemann Holger J HJ  

Blood advances 20210201 3


<h4>Background</h4>Coronavirus disease 2019 (COVID-19)-related critical illness and acute illness are associated with a risk of venous thromboembolism (VTE).<h4>Objective</h4>These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in decisions about the use of anticoagulation for thromboprophylaxis for patients with COVID-19-related critical illness and acute illness who do not have confirmed or  ...[more]

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