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American Society of Hematology living guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19: January 2022 update on the use of therapeutic-intensity anticoagulation in acutely ill patients.
Cuker, Adam; Tseng, Eric K; Nieuwlaat, Robby; Angchaisuksiri, Pantep; Blair, Clifton; Dane, Kathryn; 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 M; Skara, Mike; Terrell, Deirdra R; Touri, Kamshad; Akl, Elie A; Al Jabiri, Reyad; Al Jabiri, Yazan; Barbara, Angela M; Bognanni, Antonio; Boulos, Mary; Brignardello-Petersen, Romina; Charide, Rana; Colunga-Lozano, Luis E; Dearness, Karin; Darzi, Andrea J; Hussein, Heba; Karam, Samer G; Mansour, Razan; Morgano, Gian Paolo; Morsi, Rami Z; Muti-Schünemann, Giovanna; Nadim, Menatalla K; Philip, Binu A; Qiu, Yuan; Benitez, Yetiani Roldan; 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; Division of Hematology/Oncology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
  • Nieuwlaat R; Department of Health Research Methods, Evidence, and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, 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.
  • DeSancho MT; Division of Hematology-Oncology, Department of Medicine, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY.
  • Diuguid D; Division of Hematology, and.
  • Griffin DO; Division of Infectious Diseases, College of Physicians & Surgeons of 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 Medicine - Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands.
  • Pai A; Section of Hematology, Yale School of Medicine, New Haven, CT.
  • Righini M; Department of Internal Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
  • Sanfilippo KM; Division of Hematology & Oncology, Kaiser Permanente, Oakland/Richmond, CA.
  • Siegal DM; Division of Angiology and Hemostasis, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
  • Skara M; 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.
  • Al Jabiri R; Toronto, ON, Canada.
  • Al Jabiri Y; Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.
  • Barbara AM; University of Jordan, Amman, Jordan.
  • Bognanni A; Lincoln Medical Center, Bronx, NY.
  • Boulos M; Department of Health Research Methods, Evidence, and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, Hamilton, ON, Canada.
  • Brignardello-Petersen R; Department of Health Research Methods, Evidence, and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, Hamilton, ON, Canada.
  • Charide R; Department of Health Research Methods, Evidence, and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, Hamilton, ON, Canada.
  • Colunga-Lozano LE; Department of Health Research Methods, Evidence, and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, Hamilton, ON, Canada.
  • Dearness K; Clinical Research Institute, American University of Beirut, Beirut, Lebanon.
  • Darzi AJ; Department of Clinical Medicine, Health Science Center, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico.
  • Hussein H; Library Services, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.
  • Karam SG; Department of Health Research Methods, Evidence, and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, Hamilton, ON, Canada.
  • Mansour R; Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt.
  • Morgano GP; Department of Health Research Methods, Evidence, and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, Hamilton, ON, Canada.
  • Morsi RZ; Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman, Jordan.
  • Muti-Schünemann G; Department of Health Research Methods, Evidence, and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, Hamilton, ON, Canada.
  • Nadim MK; Department of Neurology, University of Chicago, Chicago, IL.
  • Philip BA; Department of Health Research Methods, Evidence, and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, Hamilton, ON, Canada.
  • Qiu Y; Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
  • Benitez YR; Department of Health Research Methods, Evidence, and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, Hamilton, ON, Canada.
  • Stevens A; Department of Health Research Methods, Evidence, and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, Hamilton, ON, Canada.
  • Solo K; Department of Health Research Methods, Evidence, and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, Hamilton, ON, Canada.
  • Wiercioch W; Department of Health Research Methods, Evidence, and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, Hamilton, ON, Canada.
  • Mustafa RA; Department of Health Research Methods, Evidence, and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, Hamilton, ON, Canada.
  • Schünemann HJ; Department of Health Research Methods, Evidence, and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, Hamilton, ON, Canada.
Blood Adv ; 6(17): 4915-4923, 2022 09 13.
Article in English | MEDLINE | ID: covidwho-1820127
ABSTRACT

BACKGROUND:

COVID-19-related acute illness is associated with an increased risk of venous thromboembolism (VTE).

OBJECTIVE:

These evidence-based guidelines from 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 in patients with COVID-19.

METHODS:

ASH formed a multidisciplinary guideline panel that included patient representatives and applied strategies to minimize potential bias from conflicts of interest. The McMaster University GRADE Centre supported the guideline development process and performed systematic evidence reviews (through November 2021). 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 to assess evidence and make recommendations, which were subject to public comment. This is an update to guidelines published in February 2021 as part of the living phase of these guidelines.

RESULTS:

The panel made one additional recommendation. The panel issued a conditional recommendation in favor of therapeutic-intensity over prophylactic-intensity anticoagulation in patients with COVID-19-related acute illness who do not have suspected or confirmed VTE. The panel emphasized the need for an individualized assessment of risk of thrombosis and bleeding. The panel also noted that heparin (unfractionated or low molecular weight) may be preferred because of a preponderance of evidence with this class of anticoagulants.

CONCLUSION:

This conditional recommendation was based on very low certainty in the evidence, underscoring the need for additional, high-quality, randomized controlled trials comparing different intensities of anticoagulation in patients with COVID-19-related acute illness.
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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: 2022 Document Type: Article Affiliation country: Bloodadvances.2022007561

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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: 2022 Document Type: Article Affiliation country: Bloodadvances.2022007561