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PICO Questions and DELPHI Methodology for the Management of Venous Thromboembolism Associated with COVID-19
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 th...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8624706/ https://www.ncbi.nlm.nih.gov/pubmed/34834935 http://dx.doi.org/10.3390/v13112128 |
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author | Riera-Mestre, Antoni Jara-Palomares, Luis Lecumberri, Ramón Trujillo-Santos, Javier Grau, Enric Blanco-Molina, Angeles Piera Carbonell, Ana Jiménez, Sonia Frías Vargas, Manuel Fuset, Mari Paz Bellmunt-Montoya, Sergi Monreal, Manuel Jiménez, David |
author_facet | Riera-Mestre, Antoni Jara-Palomares, Luis Lecumberri, Ramón Trujillo-Santos, Javier Grau, Enric Blanco-Molina, Angeles Piera Carbonell, Ana Jiménez, Sonia Frías Vargas, Manuel Fuset, Mari Paz Bellmunt-Montoya, Sergi Monreal, Manuel Jiménez, David |
author_sort | Riera-Mestre, Antoni |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-8624706 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-86247062021-11-27 PICO Questions and DELPHI Methodology for the Management of Venous Thromboembolism Associated with COVID-19 Riera-Mestre, Antoni Jara-Palomares, Luis Lecumberri, Ramón Trujillo-Santos, Javier Grau, Enric Blanco-Molina, Angeles Piera Carbonell, Ana Jiménez, Sonia Frías Vargas, Manuel Fuset, Mari Paz Bellmunt-Montoya, Sergi Monreal, Manuel Jiménez, David Viruses Article 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. MDPI 2021-10-22 /pmc/articles/PMC8624706/ /pubmed/34834935 http://dx.doi.org/10.3390/v13112128 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Riera-Mestre, Antoni Jara-Palomares, Luis Lecumberri, Ramón Trujillo-Santos, Javier Grau, Enric Blanco-Molina, Angeles Piera Carbonell, Ana Jiménez, Sonia Frías Vargas, Manuel Fuset, Mari Paz Bellmunt-Montoya, Sergi Monreal, Manuel Jiménez, David PICO Questions and DELPHI Methodology for the Management of Venous Thromboembolism Associated with COVID-19 |
title | PICO Questions and DELPHI Methodology for the Management of Venous Thromboembolism Associated with COVID-19 |
title_full | PICO Questions and DELPHI Methodology for the Management of Venous Thromboembolism Associated with COVID-19 |
title_fullStr | PICO Questions and DELPHI Methodology for the Management of Venous Thromboembolism Associated with COVID-19 |
title_full_unstemmed | PICO Questions and DELPHI Methodology for the Management of Venous Thromboembolism Associated with COVID-19 |
title_short | PICO Questions and DELPHI Methodology for the Management of Venous Thromboembolism Associated with COVID-19 |
title_sort | pico questions and delphi methodology for the management of venous thromboembolism associated with covid-19 |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8624706/ https://www.ncbi.nlm.nih.gov/pubmed/34834935 http://dx.doi.org/10.3390/v13112128 |
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