PICO Questions and DELPHI Methodology for the Management of Venous Thromboembolism Associated with COVID-19
Riera Mestre, Antoni (Institut d'Investigació Biomèdica de Bellvitge)
Jara-Palomares, Luis (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Lecumberri, Ramón (Clínica Universidad de Navarra)
Trujillo-Santos, Javier (Hospital General Universitario Santa Lucía (Cartagena, Múrcia))
Grau, Enric (Hospital Lluís Alcanyís de Xàtiva)
Blanco-Molina, Angeles (Hospital Universitario Reina Sofía (Còrdova, Espanya))
Piera Carbonell, Ana (Luanco Health Center)
Jiménez, Sonia (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Frías Vargas, Manuel (Comillas Health Center)
Fuset, Mari Paz (Institut d'Investigació Biomèdica de Bellvitge)
Bellmunt Montoya, Sergi (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Monreal, Manuel (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Jiménez, David (Hospital Universitario Ramón y Cajal (Madrid))
Universitat Autònoma de Barcelona. Departament de Cirurgia

Data:	2021
Resum:	Patients with coronavirus disease 2019 (COVID-19) have a higher risk of venous thromboembolic disease (VTE) than patients with other infectious or inflammatory diseases, both as macrothrombosis (pulmonar embolism and deep vein thrombosis) or microthrombosis. However, the use of anticoagulation in this scenario remains controversial. This is a project that used DELPHI methodology to answer PICO questions related to anticoagulation in patients with COVID-19. The objective was to reach a consensus among multidisciplinary VTE experts providing answers to those PICO questions. Seven PICO questions regarding patients with COVID-19 responded with a broad consensus: 1. It is recommended to avoid pharmacological thromboprophylaxis in most COVID-19 patients not requiring hospital admission; 2. In most hospitalized patients for COVID-19 who are receiving oral anticoagulants before admission, it is recommended to replace them by low molecular weight heparin (LMWH) at therapeutic doses; 3. Thromboprophylaxis with LMWH at standard doses is suggested for COVID-19 patients admitted to a conventional hospital ward; 4. Standard-doses thromboprophylaxis with LMWH is recommended for COVID-19 patients requiring admission to Intensive Care Unit; 5. It is recommended not to determine D-Dimer levels routinely in COVID-19 hospitalized patients to select those in whom VTE should be suspected, or as a part of the diagnostic algorithm to rule out or confirm a VTE event; 6. It is recommended to discontinue pharmacological thromboprophylaxis at discharge in most patients hospitalized for COVID-19; 7. It is recommended to withdraw anticoagulant treatment after 3 months in most patients with a VTE event associated with COVID-19. The combination of PICO questions and DELPHI methodology provides a consensus on different recommendations for anticoagulation management in patients with COVID-19.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Venous thromboembolic disease ; COVID-19 ; Coronavirus ; Pulmonary embolism ; Deep vein thrombosis ; Anticoagulation
Publicat a:	Viruses, Vol. 13, Num. 11 (october 2021) , ISSN 1999-4915

DOI: 10.3390/v13112128
PMID: 34834935

12 p, 292.8 KB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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