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

被引：53

作者：

Cuker, Adam ^{[1
]}

Tseng, Eric K. ^{[2
]}

Nieuwlaat, Robby ^{[3
]}

Angchaisuksiri, Pantep ^{[4
]}

Blair, Clifton

Dane, Kathryn ^{[5
]}

Davila, Jennifer ^{[6
]}

DeSancho, Maria T. ^{[7
]}

Diuguid, David ^{[8
]}

Griffin, Daniel O. ^{[9
,10
,11
]}

Kahn, Susan R. ^{[12
]}

Klok, Frederikus A. ^{[13
]}

Lee, Alfred Ian ^{[14
]}

Neumann, Ignacio ^{[15
]}

Pai, Ashok ^{[16
]}

Righini, Marc ^{[17
]}

Sanfilippo, Kristen M. ^{[18
]}

Siegal, Deborah ^{[19
,20
]}

Skara, Mike

Terrell, Deirdra R. ^{[21
]}

Touri, Kamshad

Akl, Elie A. ^{[22
]}

Akl, Imad Bou ^{[22
]}

Bognanni, Antonio ^{[3
]}

Boulos, Mary ^{[23
]}

Brignardello-Petersen, Romina ^{[3
]}

Charide, Rana ^{[24
]}

Chan, Matthew ^{[25
]}

Dearness, Karin ^{[26
]}

Darzi, Andrea J. ^{[3
]}

Kolb, Philipp ^{[23
]}

Colunga-Lozano, Luis E. ^{[27
]}

Mansour, Razan ^{[28
]}

Morgano, Gian Paolo ^{[3
]}

Morsi, Rami Z. ^{[29
]}

Muti-Schunemann, Giovanna ^{[3
]}

Noori, Atefeh ^{[3
,30
]}

Philip, Binu A. ^{[3
]}

Piggott, Thomas ^{[3
]}

Qiu, Yuan ^{[23
]}

Roldan, Yetiani ^{[3
]}

Schuenemann, Finn ^{[31
]}

Stevens, Adrienne ^{[3
]}

Solo, Karla ^{[3
]}

Wiercioch, Wojtek ^{[3
]}

Mustafa, Reem A. ^{[3
,32
]}

Schuenemann, Holger J. ^{[3
,33
]}

机构：

[1] Univ Penn, Perelman Sch Med, Dept Med, Philadelphia, PA 19104 USA

[2] Univ Toronto, Div Hematol Oncol, St Michaels Hosp, Toronto, ON, Canada

[3] McMaster Univ, McGRADE Ctr, Dept Hlth Res Methods Evidence & Impact, Michael G DeGroote Cochrane Canada, Hamilton, ON, Canada

[4] Mahidol Univ, Ramathibodi Hosp, Dept Med, Div Hematol, Bangkok, Thailand

[5] Johns Hopkins Univ Hosp, Dept Pharm, Baltimore, MD 21287 USA

[6] Childrens Hosp Montefiore, Albert Einstein Coll Med, Div Pediat Hematol Oncol & Cellular Therapies, Bronx, NY USA

[7] Weill Cornell Med, Dept Med, Div Hematol Oncol, New York Presbyterian Hosp, New York, NY USA

[8] Columbia Univ, Coll Phys & Surg, Dept Med, New York, NY USA

[9] Columbia Univ, Coll Phys & Surg, Dept Med, Div Infect Dis, New York, NY USA

[10] United Hlth Grp, Res & Dev, Minnetonka, MN USA

[11] Prohlth NY, Lake Success, NY USA

[12] McGill Univ, Dept Med, Montreal, PQ, Canada

[13] Leiden Univ, Dept Internal Med Thrombosis & Hemostasis, Med Ctr, Leiden, Netherlands

[14] Yale Univ, Sch Med, Sect Hematol, New Haven, CT USA

[15] Pontificia Univ Catolica Chile, Dept Internal Med, Santiago, Chile

[16] Kaiser Permanente, Div Hematol & Oncol, Oakland, CA USA

[17] Univ Geneva, Geneva Univ Hosp, Fac Med, Div Angiol & Hemostasis, Geneva, Switzerland

[18] Washington Univ, Dept Med, Sch Med St Louis, St Louis, MO USA

[19] Univ Ottawa, Dept Med, Ottawa, ON, Canada

[20] Univ Ottawa, Ottawa Hosp, Res Inst, Ottawa, ON, Canada

[21] Univ Oklahoma, Ctr Hlth Sci, Dept Biostat & Epidemiol, Hudson Coll Publ Hlth, Oklahoma City, OK USA

[22] Amer Univ Beirut, Dept Internal Med, Beirut, Lebanon

[23] McMaster Univ, Michael G DeGroote Sch Med, Hamilton, ON, Canada

[24] Amer Univ Beirut, Clin Res Inst, Beirut, Lebanon

[25] McMaster Univ, Dept Med, Hamilton, ON, Canada

[26] St Josephs Healthcare Hamilton, Lib Serv, Hamilton, ON, Canada

[27] Univ Guadalajara, Hlth Sci Ctr, Dept Clin Med, Guadalajara, Jalisco, Mexico

[28] King Hussein Canc Ctr, Off Sci Affairs & Res, Amman, Jordan

[29] Univ Chicago, Dept Neurol, 5841 S Maryland Ave, Chicago, IL 60637 USA

[30] McMaster Univ, Michael G DeGroote Natl Pain Ctr, Hamilton, ON, Canada

[31] Albert Ludwigs Univ Freiburg, Med Fak, Freiburg, Germany

[32] Univ Kansas, Dept Internal Med, Div Nephrol, Med Ctr, Lawrence, KS 66045 USA

[33] Univ Freiburg, Fac Med, Med Ctr, Inst Evidence Med, Freiburg, Germany

来源：

BLOOD ADVANCES | 2021年 / 5卷 / 20期

基金：

美国国家卫生研究院;

关键词：

SEVERE RENAL-INSUFFICIENCY; MOLECULAR-WEIGHT HEPARIN; PROPHYLACTIC ANTICOAGULATION; VENOUS THROMBOEMBOLISM; INTERNATIONAL NETWORK; ENOXAPARIN; EPIDEMIOLOGY; MANAGEMENT; THROMBOSIS; SAFETY;

D O I：

10.1182/bloodadvances.2021005493

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：3951 / 3959

页数：9

共 60 条

[1] COVID-19 and coagulation: bleeding and thrombotic manifestations of SARS-CoV-2 infection [J].

Al-Samkari, Hanny ;

Leaf, Rebecca S. Karp ;

Dzik, Walter H. ;

Carlson, Jonathan C. T. ;

Fogerty, Annemarie E. ;

Waheed, Anem ;

Goodarzi, Katayoon ;

Bendapudi, Pavan K. ;

Bornikova, Larissa ;

Gupta, Shruti ;

Leaf, David E. ;

Kuter, David J. ;

Rosovsky, Rachel P. .

BLOOD, 2020, 136 (04) :489-500

[2] GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 1: Introduction [J].

Alonso-Coello, Pablo ;

Schunemann, Holger J. ;

Moberg, Jenny ;

Brignardello-Petersen, Romina ;

Akl, Elie A. ;

Davoli, Marina ;

Treweek, Shaun ;

Mustafa, Reem A. ;

Rada, Gabriel ;

Rosenbaum, Sarah ;

Morelli, Angela ;

Guyatt, Gordon H. ;

Oxman, Andrew D. .

BMJ-BRITISH MEDICAL JOURNAL, 2016, 353

[3] Relationship of activated partial thromboplastin time to coronary events and bleeding in patients with acute coronary syndromes who receive heparin [J].

Anand, SS ;

Yusuf, S ;

Pogue, J ;

Ginsberg, JS ;

Hirsh, J .

CIRCULATION, 2003, 107 (23) :2884-2888

[4] Adjunctive Intermittent Pneumatic Compression for Venous Thromboprophylaxis [J].

Arabi, Y. M. ;

Al-Hameed, F. ;

Burns, K. E. A. ;

Mehta, S. ;

Alsolamy, S. J. ;

Alshahrani, M. S. ;

Mandourah, Y. ;

Almekhlafi, G. A. ;

Almaani, M. ;

Al Bshabshe, A. ;

Finfer, S. ;

Arshad, Z. ;

Khalid, I. ;

Mehta, Y. ;

Gaur, A. ;

Hawa, H. ;

Buscher, H. ;

Lababidi, H. ;

Al Aithan, A. ;

Abdukahil, S. A. I. ;

Jose, J. ;

Afesh, L. Y. ;

Al-Dawood, A. .

NEW ENGLAND JOURNAL OF MEDICINE, 2019, 380 (14) :1305-1315

[5] Systems for grading the quality of evidence and the strength of recommendations -: I:: Critical appraisal of existing approaches The GRADE Working Group -: art. no. 38 [J].

Atkins, D ;

Eccles, M ;

Flottorp, S ;

Guyatt, GH ;

Henry, D ;

Hill, S ;

Liberati, A ;

O'Connell, D ;

Oxman, AD ;

Phillips, B ;

Schünemann, H ;

Edejer, TTT ;

Vist, GE ;

Williams, JW .

BMC HEALTH SERVICES RESEARCH, 2004, 4 (1)

[6] Thromboembolism and anticoagulant therapy during the COVID-19 pandemic: interim clinical guidance from the anticoagulation forum [J].

Barnes, Geoffrey D. ;

Burnett, Allison ;

Allen, Arthur ;

Blumenstein, Marilyn ;

Clark, Nathan P. ;

Cuker, Adam ;

Dager, William E. ;

Deitelzweig, Steven B. ;

Ellsworth, Stacy ;

Garcia, David ;

Kaatz, Scott ;

Minichiello, Tracy .

JOURNAL OF THROMBOSIS AND THROMBOLYSIS, 2020, 50 (01) :72-81

[7] Therapeutic versus prophylactic anticoagulation for severe COVID-19: A randomized phase II clinical trial (HESACOVID) [J].

Bertoldi Lemos, Anna Cristina ;

do Espirito Santo, Douglas Alexandre ;

Salvetti, Maisa Cabetti ;

Gilio, Renato Noffs ;

Agra, Lucas Barbosa ;

Pazin-Filho, Antonio ;

Miranda, Carlos Henrique .

THROMBOSIS RESEARCH, 2020, 196 :359-366

[8] COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow [J].

Bikdeli, Behnood ;

Madhavan, Mahesh V. ;

Jimenez, David ;

Chuich, Taylor ;

Dreyfus, Isaac ;

Driggin, Elissa ;

Der Nigoghossian, Caroline ;

Ageno, Walter ;

Madjid, Mohammad ;

Guo, Yutao ;

Tang, Liang V. ;

Hu, Yu ;

Giri, Jay ;

Cushman, Mary ;

Quere, Isabelle ;

Dimakakos, Evangelos P. ;

Gibson, C. Michael ;

Lippi, Giuseppe ;

Favaloro, Emmanuel J. ;

Fareed, Jawed ;

Caprini, Joseph A. ;

Tafur, Alfonso J. ;

Burton, John R. ;

Francese, Dominic P. ;

Wang, Elizabeth Y. ;

Falanga, Anna ;

McLintock, Claire ;

Hunt, Beverley J. ;

Spyropoulos, Alex C. ;

Barnes, Geoffrey D. ;

Eikelboom, John W. ;

Weinberg, Ido ;

Schulman, Sam ;

Carrier, Marc ;

Piazza, Gregory ;

Beckman, Joshua A. ;

Steg, Gabriel ;

Stone, Gregg W. ;

Rosenkranz, Stephan ;

Goldhaber, Samuel Z. ;

Parikh, Sahil A. ;

Monreal, Manuel ;

Krumholz, Harlan M. ;

Konstantinides, Stavros V. ;

Weitz, Jeffrey I. ;

Lip, Gregory Y. H. .

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2020, 75 (23) :2950-2973

[9] Determining the safety of enoxaparin prophylaxis in critically ill patients with severe renal insufficiency - The PACER pilot study [J].

Castellucci, Lana A. ;

Shaw, Joseph ;

Giulivi, Antonio ;

Edwards, Cedrick ;

Carrier, Marc ;

Patel, Rakesh .

THROMBOSIS RESEARCH, 2016, 144 :69-71

[10] Epidemiology of venous thromboembolism in a Chinese population [J].

Cheuk, BLY ;

Cheung, GCY ;

Cheng, SWK .

BRITISH JOURNAL OF SURGERY, 2004, 91 (04) :424-428

← 1 2 3 4 5 6 →