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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
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.
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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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