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Cited by 408Venous Thromboembolism Diagnosis and ManagementCOVID-19 Clinical Research StudiesBlood Coagulation and Thrombosis Mechanisms

American Society of Hematology 2021 guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19

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Cuker, Adam, Tseng, Eric K., Nieuwlaat, Robby, Angchaisuksiri, Pantep, Blair, Clifton, Dane, Kathryn, Davila, Jennifer, DeSancho, Maria T. +37 more·2021·Blood Advances
DOI 10.1182/bloodadvances.2020003763PMC PMC7869684
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Abstract

Background: Coronavirus disease 2019 (COVID-19)–related critical illness and acute illness are associated with a 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 for patients with COVID-19–related critical illness and acute illness who do not have confirmed or suspected VTE. Methods: ASH formed a multidisciplinary guideline panel and applied strict management strategies to minimize potential bias from conflicts of interest. The panel included 3 patient representatives. The McMaster University GRADE Centre supported the guideline-development process, including performing systematic evidence reviews (up to 19 August 2020). 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, including GRADE Evidence-to-Decision frameworks, to assess evidence and make recommendations, which were subject to public comment. Results: The panel agreed on 2 recommendations. The panel issued conditional recommendations in favor of prophylactic-intensity anticoagulation over intermediate-intensity or therapeutic-intensity anticoagulation for patients with COVID-19–related critical illness or acute illness who do not have confirmed or suspected VTE. Conclusions: These recommendations were based on very low certainty in the evidence, underscoring the need for high-quality, randomized controlled trials comparing different intensities of anticoagulation. They will be updated using a living recommendation approach as new evidence becomes available.

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  • COVID-19 is associated with thromboembolism and clotting, driven by factors including complement and mast cell activation.

    “COVID-19 is also associated with thromboembolism and clotting, which is driven by a number of factors including complement and mast cell activation. 147,148”

    From COVID-19, Myocarditis and Pericarditis (2023) · cites this paper as [147]

    The Introduction (‘Description of the health problem’; page not provided) describes venous thromboembolism, thrombosis, and hypercoagulability in patients hospitalized with COVID-19. It says the mechanisms are not fully understood and does not identify complement or mast cell activation as drivers; searches for those terms found no supporting passage. (LLM, conf=0.87)

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References 93 · Cited by 408

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Authors
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., Pai, M., Righini, M., Sanfilippo, K. M., Siegal, D., Skara, M., Touri, K., A. Akl, E., Bou Akl, I., Boulos, M., Brignardello-Petersen, R., Charide, R., Chan, M., Dearness, K., Darzi, A. J., Kolb, P., Colunga-Lozano, L. E., Mansour, R., Morgano, G. P., Morsi, R. Z., Noori, A., Piggott, T., Qiu, Y., Roldan, Y., Schünemann, F., Stevens, A., Solo, K., Ventresca, M., Wiercioch, W., Mustafa, R. A., & Schünemann, H. J.
Affiliations
  • University of Pennsylvania (US)
  • St. Michael's Hospital (CA)
  • Michael G. DeGroote Cochrane Canada Centre (CA)
  • Mahidol University (TH)
  • Union, NJ;
  • Johns Hopkins University (US)
  • Albert Einstein College of Medicine (US)
  • NewYork–Presbyterian Hospital (US)
  • Department of Medicine, College of Physicians and Surgeons and
  • UnitedHealth Group (United States) (US)
  • McGill University (CA)
  • Leiden University Medical Center (NL)
  • Yale University (US)
  • Pontificia Universidad Católica de Chile (CL)
  • Kaiser Permanente (US)
  • McMaster University (CA)
  • University of Geneva (CH)
  • Washington University in St. Louis (US)
  • University of Ottawa (CA)
  • Cottage Grove, MN;
  • Toronto, ON, Canada;
  • Department of Internal Medicine, American University of Beirut, Beirut, Lebanon;
  • Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada;
  • American University of Beirut (LB)
  • St. Joseph’s Healthcare Hamilton (CA)
  • Department of Clinical Medicine, Health Science Center, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico;
  • King Hussein Cancer Center (JO)
  • University of Chicago (US)
  • University of Freiburg (DE)
  • University of Kansas Medical Center (US)
Corresponding author
Cuker, Adam
ORCID
Venue
Blood Advances
Publisher
American Society of Hematology
Published
2021-02-08
Volume
5
Issue
3
Pages
872-888
ISSN
  • 2473-9529 (ISSN-L)
  • 2473-9537
DOI
10.1182/bloodadvances.2020003763
PMC
PMC7869684
OpenAlex
W3128604271
Cited by
408
References
93
Citations by year
2026: 8 · 2025: 13 · 2024: 45 · 2023: 64 · 2022: 131 · 2021: 146
FWCI
76.60
Type
journal article
Language
en
Open access
Licence
cc-by-nc-nd
Locations
  • Blood Advances (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Archive ouverte UNIGE (University of Geneva) (publishedVersion, other-oa)
  • Digital Commons@Becker (Washington University School of Medicine) (submittedVersion)
  • Leiden Repository (Leiden University) (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
  • MacSphere (McMaster University) (submittedVersion)
  • Archive ouverte UNIGE (University of Geneva) (submittedVersion, other-oa)
Funders
  • National Institutes of Health (UL1TR001863)
  • National Center for Advancing Translational Sciences
Topics
  • Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
  • Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
Keywords
COVID-19 pandemic, anticoagulation, thromboprophylaxis, venous thromboembolism, critical illness, acute illness, GRADE
MeSH terms
COVID-19, SARS-CoV-2, Anticoagulants, Humans, Societies, Medical, Guidelines as Topic, Enoxaparin, Evidence-Based Medicine, Venous Thromboembolism

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Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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