Good practice statements for antithrombotic therapy in the management of COVID‐19: Guidance from the SSC of the ISTH

Despite the emergence of high quality randomized trial data with the use of antithrombotic agents to reduce the risk of thromboembolism, end‐organ failure, and possibly mortality in patients with coronavirus disease 2019 (COVID‐19), questions still remain as to optimal patient selection for these st...

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Published in:Journal of thrombosis and haemostasis Vol. 20; no. 10; pp. 2226 - 2236
Main Authors: Spyropoulos, Alex C., Connors, Jean M., Douketis, James D., Goldin, Mark, Hunt, Beverley J., Kotila, Taiwo R., Lopes, Renato D., Schulman, Sam, the International Society on Thrombosis and Haemostasis
Format: Journal Article
Language:English
Published: England Elsevier Inc 01.10.2022
Elsevier Limited
John Wiley and Sons Inc
Subjects:
anticoagulant
Anticoagulants - therapeutic use
antiplatelet
Antiplatelet therapy
antithrombotic therapy
coronavirus disease 2019
Coronaviruses
COVID-19
COVID-19 Drug Treatment
Critical care
Fibrinolytic Agents - therapeutic use
Hemostasis
hospitalization
Humans
Patients
Platelet Aggregation Inhibitors - therapeutic use
Recommendations and Guidelines
severe acute respiratory syndrome coronavirus 2
Thromboembolism
Thrombosis
Thrombosis - drug therapy
Thrombosis - prevention & control
Venous Thromboembolism - prevention & control
anticoagulant
antithrombotic therapy
hospitalization
severe acute respiratory syndrome coronavirus 2
antiplatelet
coronavirus disease 2019
ISSN:1538-7836, 1538-7933, 1538-7836
Online Access:Get full text
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Summary:Despite the emergence of high quality randomized trial data with the use of antithrombotic agents to reduce the risk of thromboembolism, end‐organ failure, and possibly mortality in patients with coronavirus disease 2019 (COVID‐19), questions still remain as to optimal patient selection for these strategies, the use of antithrombotics in outpatient settings and in‐hospital settings (including critical care units), thromboprophylaxis in special patient populations, and the management of acute thrombosis in hospitalized COVID‐19 patients. In October 2021, the International Society on Thrombosis and Haemostasis (ISTH) formed a multidisciplinary and international panel of content experts, two patient representatives, and a methodologist to develop recommendations on treatment with anticoagulants and antiplatelet agents for COVID‐19 patients. The ISTH Guideline panel discussed additional topics to be well suited to a non‐Grading of Recommendations Assessment, Development, and Evaluation (GRADE) for Good Practice Statements (GPS) to support good clinical care in the antithrombotic management of COVID‐19 patients in various clinical settings. The GPS panel agreed on 17 GPS: 3 in the outpatient (pre‐hospital) setting, 12 in the hospital setting both in non‐critical care (ward) as well as intensive care unit settings, and 2 in the immediate post‐hospital discharge setting based on limited evidence or expert opinion that supports net clinical benefit in enacting the statements provided. The antithrombotic therapies discussed in these GPS should be available in low‐ and middle‐income countries.
Bibliography:Manuscript Handled by: Walter Ageno
Final decision: Walter Ageno, 05 Jul 2022
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ISSN:1538-7836
1538-7933
1538-7836
DOI:10.1111/jth.15809