Deborah M Siegal, Eric K Tseng, Holger J Schünemann, Pantep Angchaisuksiri, Adam Cuker, Kathryn Dane, Maria T DeSancho, David Diuguid, Daniel O Griffin, Frederikus A Klok, Alfred Ian Lee, Ignacio Neumann, Ashok Pai, Marc Righini, Kristen M Sanfilippo, Deirdra R Terrell, Elie A Akl, Reyad Al Jabiri, Yazan Al Jabiri, Angela M Barbara, Antonio Bognanni, Imad Bou Akl, Mary Boulos, Romina Brignardello-Petersen, Matthew Chan, Rana Charide, Luis E Colunga-Lozano, Karin Dearness, Andrea J Darzi, Heba Hussein, Samer G Karam, Philipp Kolb, Razan Mansour, Gian Paolo Morgano, Rami Z Morsi, Giovanna Muti-Schünemann, Menatalla K Nadim, Atefeh Noori, Binu A Philip, Thomas Piggott, Yuan Qiu, Yetiani Roldan Benitez, Finn Schünemann, Adrienne Stevens, Karla Solo, Wojtek Wiercioch, Reem A Mustafa, Robby Nieuwlaat
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引用次数: 0
Abstract
Background: COVID-19-related critical and acute illness is associated with an increased risk of venous thromboembolism (VTE). These evidence-based recommendations of the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in decisions about using anticoagulation for thromboprophylaxis for patients with COVID-19-related critical illness; patients with COVID-19-related acute illness; and those being discharged from the hospital, who do not have suspected or confirmed VTE.
Methods: ASH formed a multidisciplinary panel, including patient representatives. The Michael G. DeGroote Cochrane Canada and MacGRADE Centres at McMaster University supported guideline development, including performing systematic reviews (up to June 2023). 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 certainty in the evidence and make recommendations.
Results: This is an executive summary of 3 updated recommendations that have been published, which concludes the living phase of the guidelines. For patients with COVID-19-related critical illness, the panel issued conditional recommendations suggesting (a) prophylactic-intensity over therapeutic-intensity anticoagulation and (b) prophylactic-intensity over intermediate-intensity anticoagulation. For patients with COVID-19-related acute illness, conditional recommendations were suggested (a) prophylactic-intensity over intermediate-intensity anticoagulation, and (b) therapeutic-intensity over prophylactic-intensity anticoagulation. The panel issued a conditional recommendation suggesting against the use of postdischarge anticoagulant thromboprophylaxis.
Conclusions: These conditional recommendations were made based on low or very low certainty in the evidence, underscoring the need for additional, high-quality, randomized controlled trials for patients with COVID-19.
期刊介绍：
Blood Advances, a semimonthly medical journal published by the American Society of Hematology, marks the first addition to the Blood family in 70 years. This peer-reviewed, online-only, open-access journal was launched under the leadership of founding editor-in-chief Robert Negrin, MD, from Stanford University Medical Center in Stanford, CA, with its inaugural issue released on November 29, 2016.
Blood Advances serves as an international platform for original articles detailing basic laboratory, translational, and clinical investigations in hematology. The journal comprehensively covers all aspects of hematology, including disorders of leukocytes (both benign and malignant), erythrocytes, platelets, hemostatic mechanisms, vascular biology, immunology, and hematologic oncology. Each article undergoes a rigorous peer-review process, with selection based on the originality of the findings, the high quality of the work presented, and the clarity of the presentation.
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