Since the first cases of COVID-19 were identified in the United States, we have learned a lot however as with anything else in life, we never stop learning! Many residents in our care contracted the COVID-19 virus and required hospitalization. Some of these residents developed blood clots in the lungs, negatively impacting their recovery. Anticoagulation therapy has become common practice for these very ill patients and physicians often debate which course of therapy to take.
In June 2020, the American Society of Hematology (ASH) formed a multidisciplinary, international panel to develop guidelines on the use of anticoagulation in patients with COVID-19. The panel prioritized questions about the use of anticoagulation in critically and acutely ill patients. The McMaster University GRADE Centre supported the guideline development process. In collaboration with experts on the guidelines panel, the team conducted urgent systematic reviews of available evidence on the baseline risk of thrombosis in patients with COVID-19 and on the use of prophylactic versus higher intensity anticoagulation in patients who are acutely or critically ill. October 8, 2020, the panel agreed on the following recommendations:
Critically Ill Patients
The ASH guideline panel suggests using prophylactic-intensity over intermediate-intensity or therapeutic-intensity anticoagulation in patients with COVID-19 related critical illness who do not have suspected or confirmed VTW (conditional recommendation based on very low certainty in the evidence about effects).
Acutely Ill Patients
The ASH guideline panel suggests using prophylactic-intensity over intermediate-intensity or therapeutic-intensity anticoagulation in patients with COVID-19 related acute illness who do not have suspected or confirmed VTE (conditional recommendation based on very low certainty in the evidence about effects).
These are guidelines/suggestions are still under public review and once approved will be submitted for publication within Blood Advances. These findings may assist in the recovery process for residents with positive COVID-19. Talk to your physicians to be sure they are aware of the recent research! Stay the course, stay well, mask up and stay tuned!