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American Society of Hematology living guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19: May 2021 update on the use of intermediate-intensity anticoagulation in critically ill patients.
Cuker, Adam; Tseng, Eric K; Nieuwlaat, Robby; Angchaisuksiri, Pantep; Blair, Clifton; Dane, Kathryn; Davila, Jennifer; DeSancho, Maria T; Diuguid, David; Griffin, Daniel O; Kahn, Susan R; Klok, Frederikus A; Lee, Alfred Ian; Neumann, Ignacio; Pai, Ashok; Righini, Marc; Sanfilippo, Kristen M; Siegal, Deborah; Skara, Mike; Terrell, Deirdra R; Touri, Kamshad; Akl, Elie A; Bou Akl, Imad; Bognanni, Antonio; Boulos, Mary; Brignardello-Petersen, Romina; Charide, Rana; Chan, Matthew; Dearness, Karin; Darzi, Andrea J; Kolb, Philipp; Colunga-Lozano, Luis E; Mansour, Razan; Morgano, Gian Paolo; Morsi, Rami Z; Muti-Schünemann, Giovanna; Noori, Atefeh; Philip, Binu A; Piggott, Thomas; Qiu, Yuan; Roldan, Yetiani; Schünemann, Finn; Stevens, Adrienne; Solo, Karla; Wiercioch, Wojtek; Mustafa, Reem A; Schünemann, Holger J.
  • Cuker A; Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Tseng EK; St. Michael's Hospital, Division of Hematology/Oncology, University of Toronto, Toronto, ON, Canada.
  • Nieuwlaat R; Michael G. DeGroote Cochrane Canada, McGRADE Centre, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
  • Angchaisuksiri P; Division of Hematology, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
  • Blair C; Union, NJ.
  • Dane K; Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, MD.
  • Davila J; Children's Hospital at Montefiore, Division of Pediatric Hematology, Oncology, and Cellular Therapies, Albert Einstein College of Medicine, Bronx, NY.
  • DeSancho MT; Division of Hematology-Oncology, Department of Medicine, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY.
  • Diuguid D; Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY.
  • Griffin DO; Department of Medicine, Division of Infectious Diseases, College of Physicians and Surgeons, Columbia University, New York, NY.
  • Kahn SR; Research and Development at United Health Group, Minnetonka, MN.
  • Klok FA; Prohealth NY, Lake Success, NY.
  • Lee AI; Department of Medicine, McGill University, Montreal, QC, Canada.
  • Neumann I; Department of Internal Medicine-Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands.
  • Pai A; Section of Hematology, School of Medicine, Yale University, New Haven, CT.
  • Righini M; Department of Internal Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
  • Sanfilippo KM; Division of Hematology and Oncology, Kaiser Permanente, Oakland/Richmond, CA.
  • Siegal D; Division of Angiology and Hemostasis, Faculty of Medicine, Geneva University Hospitals, University of Geneva, Geneva, Switzerland.
  • Skara M; Department of Medicine, Washington University School of Medicine St. Louis, St. Louis, MO.
  • Terrell DR; Department of Medicine and the Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
  • Touri K; Cottage Grove, MN.
  • Akl EA; Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK.
  • Bou Akl I; Toronto, ON, Canada.
  • Bognanni A; Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.
  • Boulos M; Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.
  • Brignardello-Petersen R; Michael G. DeGroote Cochrane Canada, McGRADE Centre, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
  • Charide R; Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
  • Chan M; Michael G. DeGroote Cochrane Canada, McGRADE Centre, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
  • Dearness K; Clinical Research Institute, American University of Beirut, Beirut, Lebanon.
  • Darzi AJ; Department of Medicine, McMaster University, Hamilton, ON, Canada.
  • Kolb P; Library Services, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.
  • Colunga-Lozano LE; Michael G. DeGroote Cochrane Canada, McGRADE Centre, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
  • Mansour R; Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
  • Morgano GP; Department of Clinical Medicine, Health Science Center, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico.
  • Morsi RZ; Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman, Jordan.
  • Muti-Schünemann G; Michael G. DeGroote Cochrane Canada, McGRADE Centre, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
  • Noori A; Department of Neurology, University of Chicago, Chicago, IL.
  • Philip BA; Michael G. DeGroote Cochrane Canada, McGRADE Centre, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
  • Piggott T; Michael G. DeGroote Cochrane Canada, McGRADE Centre, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
  • Qiu Y; The Michael G. DeGroote National Pain Center, McMaster University, Hamilton, ON, Canada.
  • Roldan Y; Michael G. DeGroote Cochrane Canada, McGRADE Centre, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
  • Schünemann F; Michael G. DeGroote Cochrane Canada, McGRADE Centre, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
  • Stevens A; Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
  • Solo K; Michael G. DeGroote Cochrane Canada, McGRADE Centre, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
  • Wiercioch W; Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Germany.
  • Mustafa RA; Michael G. DeGroote Cochrane Canada, McGRADE Centre, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
  • Schünemann HJ; Michael G. DeGroote Cochrane Canada, McGRADE Centre, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Blood Adv ; 5(20): 3951-3959, 2021 10 26.
Article in English | MEDLINE | ID: covidwho-1388719
ABSTRACT

BACKGROUND:

COVID-19-related critical illness is associated with an increased 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 making decisions about the use of anticoagulation for thromboprophylaxis in patients with COVID-19-related critical illness who do not have confirmed or suspected VTE.

METHODS:

ASH formed a multidisciplinary guideline panel that included 3 patient representatives and applied strategies to minimize potential bias from conflicts of interest. The McMaster University Grading of Recommendations Assessment, Development and Evaluation (GRADE) Centre supported the guideline development process by performing systematic evidence reviews (up to 5 March 2021). The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The panel used the GRADE approach to assess evidence and make recommendations, which were subject to public comment. This is an update on guidelines published in February 2021.

RESULTS:

The panel agreed on 1 additional recommendation. The panel issued a conditional recommendation in favor of prophylactic-intensity over intermediate-intensity anticoagulation in patients with COVID-19-related critical illness who do not have confirmed or suspected VTE.

CONCLUSIONS:

This recommendation was based on low certainty in the evidence, which underscores the need for additional high-quality, randomized, controlled trials comparing different intensities of anticoagulation in critically ill patients. Other key research priorities include better evidence regarding predictors of thrombosis and bleeding risk in critically ill patients with COVID-19 and the impact of nonanticoagulant therapies (eg, antiviral agents, corticosteroids) on thrombotic risk.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Venous Thromboembolism / COVID-19 / Hematology Type of study: Experimental Studies / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Humans Country/Region as subject: North America Language: English Journal: Blood Adv Year: 2021 Document Type: Article Affiliation country: Bloodadvances.2021005493

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Venous Thromboembolism / COVID-19 / Hematology Type of study: Experimental Studies / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Humans Country/Region as subject: North America Language: English Journal: Blood Adv Year: 2021 Document Type: Article Affiliation country: Bloodadvances.2021005493