• 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, Menaka Pai, Marc Righini, Kristen M Sanfilippo, Deborah Siegal, Mike Skara, Kamshad Touri, Elie A Akl, Bou AklImadIDepartment of Internal Medicine, American University of Beirut, Beirut, Lebanon., 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, Atefeh Noori, Thomas Piggott, Yuan Qiu, Yetiani Roldan, Finn Schünemann, Adrienne Stevens, Karla Solo, Matthew Ventresca, Wojtek Wiercioch, Reem A Mustafa, and Holger J Schünemann.
• Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
• Blood Adv. 2021 Feb 9; 5 (3): 872-888.

BackgroundCoronavirus disease 2019 (COVID-19)-related critical illness and acute illness are associated with a risk of venous thromboembolism (VTE).ObjectiveThese 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.MethodsASH 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.ResultsThe 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.ConclusionsThese 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.© 2021 by The American Society of Hematology.

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