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

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; Marc Righini; Kristen M. Sanfilippo; Deborah Siegal; Mike Skara; Deirdra R. Terrell; Kamshad Touri; Elie A. Akl; Imad Bou Akl; Antonio Bognanni; 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; Giovanna Muti-Schunemann; Atefeh Noori; Binu A. Philip; Thomas Piggott; Yuan Qiu; Yetiani Roldan; Finn Schunemann; Adrienne Stevens; Karla Solo; Wojtek Wiercioch; Reem A. Mustafa; Holger J. Schunemann

doi:10.1182/bloodadvances.2021005493

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

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, Marc Righini, Kristen M. Sanfilippo, Deborah Siegal, Mike Skara, Deirdra R. TerrellKamshad Touri, Elie A. Akl, Imad Bou Akl, Antonio Bognanni, 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, Giovanna Muti-Schunemann, Atefeh Noori, Binu A. Philip, Thomas Piggott, Yuan Qiu, Yetiani Roldan, Finn Schunemann, Adrienne Stevens, Karla Solo, Wojtek Wiercioch, Reem A. Mustafa, Holger J. Schunemann

Pediatrics

Research output: Contribution to journal › Review article › peer-review

43 Scopus citations

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.

Original language	English (US)
Pages (from-to)	3951-3959
Number of pages	9
Journal	Blood Advances
Volume	5
Issue number	20
DOIs	https://doi.org/10.1182/bloodadvances.2021005493
State	Published - Oct 26 2021

ASJC Scopus subject areas

Hematology

Access to Document

10.1182/bloodadvances.2021005493

Fingerprint

Dive into the research topics of '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'. Together they form a unique fingerprint.

Cite this

Cuker, A., Tseng, E. K., Nieuwlaat, R., Angchaisuksiri, P., Blair, C., Dane, K., Davila, J., DeSancho, M. T., Diuguid, D., Griffin, D. O., Kahn, S. R., Klok, F. A., Lee, A. I., Neumann, I., Pai, A., Righini, M., Sanfilippo, K. M., Siegal, D., Skara, M., ... Schunemann, H. J. (2021). 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. Blood Advances, 5(20), 3951-3959. https://doi.org/10.1182/bloodadvances.2021005493

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 et al.
In: Blood Advances, Vol. 5, No. 20, 26.10.2021, p. 3951-3959.

Research output: Contribution to journal › Review article › peer-review

Cuker, A, Tseng, EK, Nieuwlaat, R, Angchaisuksiri, P, Blair, C, Dane, K, Davila, J, DeSancho, MT, Diuguid, D, Griffin, DO, Kahn, SR, Klok, FA, Lee, AI, Neumann, I, Pai, A, Righini, M, Sanfilippo, KM, Siegal, D, Skara, M, Terrell, DR, Touri, K, Akl, EA, Akl, IB, Bognanni, A, Boulos, M, Brignardello-Petersen, R, Charide, R, Chan, M, Dearness, K, Darzi, AJ, Kolb, P, Colunga-Lozano, LE, Mansour, R, Morgano, GP, Morsi, RZ, Muti-Schunemann, G, Noori, A, Philip, BA, Piggott, T, Qiu, Y, Roldan, Y, Schunemann, F, Stevens, A, Solo, K, Wiercioch, W, Mustafa, RA & Schunemann, HJ 2021, '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', Blood Advances, vol. 5, no. 20, pp. 3951-3959. https://doi.org/10.1182/bloodadvances.2021005493

Cuker A, Tseng EK, Nieuwlaat R, Angchaisuksiri P, Blair C, Dane K et al. 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. Blood Advances. 2021 Oct 26;5(20):3951-3959. doi: 10.1182/bloodadvances.2021005493

@article{863ff710c71b4eb6acad32e98cc6868c,

title = "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",

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.",

author = "Adam Cuker and Tseng, {Eric K.} and Robby Nieuwlaat and Pantep Angchaisuksiri and Clifton Blair and Kathryn Dane and Jennifer Davila and DeSancho, {Maria T.} and David Diuguid and Griffin, {Daniel O.} and Kahn, {Susan R.} and Klok, {Frederikus A.} and Lee, {Alfred Ian} and Ignacio Neumann and Ashok Pai and Marc Righini and Sanfilippo, {Kristen M.} and Deborah Siegal and Mike Skara and Terrell, {Deirdra R.} and Kamshad Touri and Akl, {Elie A.} and Akl, {Imad Bou} and Antonio Bognanni and Mary Boulos and Romina Brignardello-Petersen and Rana Charide and Matthew Chan and Karin Dearness and Darzi, {Andrea J.} and Philipp Kolb and Colunga-Lozano, {Luis E.} and Razan Mansour and Morgano, {Gian Paolo} and Morsi, {Rami Z.} and Giovanna Muti-Schunemann and Atefeh Noori and Philip, {Binu A.} and Thomas Piggott and Yuan Qiu and Yetiani Roldan and Finn Schunemann and Adrienne Stevens and Karla Solo and Wojtek Wiercioch and Mustafa, {Reem A.} and Schunemann, {Holger J.}",

year = "2021",

month = oct,

day = "26",

doi = "10.1182/bloodadvances.2021005493",

language = "English (US)",

volume = "5",

pages = "3951--3959",

journal = "Blood Advances",

issn = "2473-9529",

publisher = "American Society of Hematology",

number = "20",

}

TY - JOUR

T1 - American Society of Hematology living guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19

T2 - May 2021 update on the use of intermediate-intensity anticoagulation in critically ill patients

AU - Cuker, Adam

AU - Tseng, Eric K.

AU - Nieuwlaat, Robby

AU - Angchaisuksiri, Pantep

AU - Blair, Clifton

AU - Dane, Kathryn

AU - Davila, Jennifer

AU - DeSancho, Maria T.

AU - Diuguid, David

AU - Griffin, Daniel O.

AU - Kahn, Susan R.

AU - Klok, Frederikus A.

AU - Lee, Alfred Ian

AU - Neumann, Ignacio

AU - Pai, Ashok

AU - Righini, Marc

AU - Sanfilippo, Kristen M.

AU - Siegal, Deborah

AU - Skara, Mike

AU - Terrell, Deirdra R.

AU - Touri, Kamshad

AU - Akl, Elie A.

AU - Akl, Imad Bou

AU - Bognanni, Antonio

AU - Boulos, Mary

AU - Brignardello-Petersen, Romina

AU - Charide, Rana

AU - Chan, Matthew

AU - Dearness, Karin

AU - Darzi, Andrea J.

AU - Kolb, Philipp

AU - Colunga-Lozano, Luis E.

AU - Mansour, Razan

AU - Morgano, Gian Paolo

AU - Morsi, Rami Z.

AU - Muti-Schunemann, Giovanna

AU - Noori, Atefeh

AU - Philip, Binu A.

AU - Piggott, Thomas

AU - Qiu, Yuan

AU - Roldan, Yetiani

AU - Schunemann, Finn

AU - Stevens, Adrienne

AU - Solo, Karla

AU - Wiercioch, Wojtek

AU - Mustafa, Reem A.

AU - Schunemann, Holger J.

PY - 2021/10/26

Y1 - 2021/10/26

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85118298426&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85118298426&partnerID=8YFLogxK

U2 - 10.1182/bloodadvances.2021005493

DO - 10.1182/bloodadvances.2021005493

M3 - Review article

C2 - 34474482

AN - SCOPUS:85118298426

SN - 2473-9529

VL - 5

SP - 3951

EP - 3959

JO - Blood Advances

JF - Blood Advances

IS - 20

ER -

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

Abstract

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this