American Society of Hematology living guidelines on the use of anticoagulation for thromboprophylaxis for patients with COVID-19: March 2022 update on the use of anticoagulation in critically ill patients. Academic Article uri icon

Overview

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 decisions about the use of anticoagulation for patients with COVID-19. METHODS: ASH formed a multidisciplinary guideline panel, including 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, including performing systematic evidence reviews (up to January 2022). 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 to guidelines published in February 2021 and May 2021 as part of the living phase of these guidelines. RESULTS: The panel made 1 additional recommendation: a conditional recommendation for the use of prophylactic-intensity over therapeutic-intensity anticoagulation for patients with COVID-19-related critical illness who do not have suspected or confirmed VTE. The panel emphasized the need for an individualized assessment of thrombotic and bleeding risk. CONCLUSIONS: 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 for patients with COVID-19-related critical illness.

authors

  • Cuker, Adam
  • Tseng, Eric K
  • Schünemann, Holger J
  • Angchaisuksiri, Pantep
  • Blair, Clifton
  • Dane, Kathryn
  • DeSancho, Maria Teresa
  • 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
  • Boulos, Mary
  • Brignardello-Petersen, Romina
  • Charide, Rana
  • Colunga-Lozano, Luis E
  • Dearness, Karin
  • Darzi, Andrea J
  • Karam, Samer G
  • Morgano, Gian Paolo
  • Morsi, Rami Z
  • Philip, Binu A
  • Benitez, Yetiani Roldan
  • Stevens, Adrienne
  • Solo, Karla
  • Wiercioch, Wojtek
  • Mustafa, Reem A
  • Nieuwlaat, Robby

publication date

  • September 13, 2022

Research

keywords

  • COVID-19
  • Hematology
  • Venous Thromboembolism

Identity

PubMed Central ID

  • PMC9236618

Scopus Document Identifier

  • 85138066187

Digital Object Identifier (DOI)

  • 10.1182/bloodadvances.2022007940

PubMed ID

  • 35748885

Additional Document Info

volume

  • 6

issue

  • 17