American Society of Hematology living guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19: July 2021 update on postdischarge thromboprophylaxis
Issued Date
2022-01-25
Resource Type
ISSN
24739529
eISSN
24739537
Scopus ID
2-s2.0-85122980519
Pubmed ID
34727173
Journal Title
Blood Advances
Volume
6
Issue
2
Start Page
664
End Page
671
Rights Holder(s)
SCOPUS
Bibliographic Citation
Blood Advances Vol.6 No.2 (2022) , 664-671
Suggested Citation
Cuker A. American Society of Hematology living guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19: July 2021 update on postdischarge thromboprophylaxis. Blood Advances Vol.6 No.2 (2022) , 664-671. 671. doi:10.1182/bloodadvances.2021005945 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/86197
Title
American Society of Hematology living guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19: July 2021 update on postdischarge thromboprophylaxis
Author(s)
Author's Affiliation
Faculty of Dentistry
Ramathibodi Hospital
L’École de médecine
Michael G. DeGroote School of Medicine
School of Medicine
Michael G. DeGroote National Pain Centre
Albert Ludwigs Universität Freiburg, Medizinische Fakultät
American University of Beirut
The University of Jordan
King Hussein Cancer Center
McMaster University
University of Oklahoma Health Sciences Center
Pontificia Universidad Católica de Chile
The University of Chicago
Universitätsklinikum Freiburg
Washington University School of Medicine in St. Louis
New York Presbyterian Hospital
Yale School of Medicine
Kaiser Permanente
Saint Michael's Hospital University of Toronto
University of Toronto
Leids Universitair Medisch Centrum
Faculty of Medicine - Ain Shams University
Vagelos College of Physicians and Surgeons
St. Joseph's Healthcare Hamilton
Hôpitaux Universitaires de Genève
Universidad de Guadalajara
University of Kansas Medical Center
University of Pennsylvania Perelman School of Medicine
Albert Einstein College of Medicine of Yeshiva University
Lincoln Medical and Mental Health Center
The Johns Hopkins Hospital
Research and Development
Prohealth NY
UNION
Ramathibodi Hospital
L’École de médecine
Michael G. DeGroote School of Medicine
School of Medicine
Michael G. DeGroote National Pain Centre
Albert Ludwigs Universität Freiburg, Medizinische Fakultät
American University of Beirut
The University of Jordan
King Hussein Cancer Center
McMaster University
University of Oklahoma Health Sciences Center
Pontificia Universidad Católica de Chile
The University of Chicago
Universitätsklinikum Freiburg
Washington University School of Medicine in St. Louis
New York Presbyterian Hospital
Yale School of Medicine
Kaiser Permanente
Saint Michael's Hospital University of Toronto
University of Toronto
Leids Universitair Medisch Centrum
Faculty of Medicine - Ain Shams University
Vagelos College of Physicians and Surgeons
St. Joseph's Healthcare Hamilton
Hôpitaux Universitaires de Genève
Universidad de Guadalajara
University of Kansas Medical Center
University of Pennsylvania Perelman School of Medicine
Albert Einstein College of Medicine of Yeshiva University
Lincoln Medical and Mental Health Center
The Johns Hopkins Hospital
Research and Development
Prohealth NY
UNION
Other Contributor(s)
Abstract
Background: COVID-19-related acute 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 thromboprophylaxis in patients with COVID-19 who do not have confirmed or suspected VTE. 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 GRADE Centre supported the guideline development process, including performing systematic evidence reviews (up to March 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. Results: The panel agreed on 1 additional recommendation. The panel issued a conditional recommendation against the use of outpatient anticoagulant prophylaxis in patients with COVID-19 who are discharged from the hospital and who do not have suspected or confirmed VTE or another indication for anticoagulation. Conclusions: This recommendation was based on very low certainty in the evidence, underscoring the need for high-quality randomized controlled trials assessing the role of postdischarge thromboprophylaxis. Other key research priorities include better evidence on assessing risk of thrombosis and bleeding outcomes in patients with COVID-19 after hospital discharge.