Coronavirus disease 2019 (COVID-19)-related critical illness and acute illness are associated with a risk of venous thromboembolism (VTE).
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.
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.
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.
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.
About The Expert
Adam Cuker
Eric K Tseng
Robby Nieuwlaat
Pantep Angchaisuksiri
Clifton Blair
Kathryn Dane
Jennifer Davila
Maria T DeSancho
David Diuguid
Daniel O Griffin
Susan R Kahn
Frederikus A Klok
Alfred Ian Lee
Ignacio Neumann
Ashok Pai
Menaka Pai
Marc Righini
Kristen M Sanfilippo
Deborah Siegal
Mike Skara
Kamshad Touri
Elie A Akl
Imad Bou Akl
Mary Boulos
Romina Brignardello-Petersen
Rana Charide
Matthew Chan
Karin Dearness
Andrea J Darzi
Philipp Kolb
Luis E Colunga-Lozano
Razan Mansour
Gian Paolo Morgano
Rami Z Morsi
Atefeh Noori
Thomas Piggott
Yuan Qiu
Yetiani Roldan
Finn Schünemann
Adrienne Stevens
Karla Solo
Matthew Ventresca
Wojtek Wiercioch
Reem A Mustafa
Holger J Schünemann
References
PubMed
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