Evidence map›Paper›PMID 34474482›Full record

GuidelineBlood advances2021

American Society of Hematology living guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19: May 2021 update on the use of intermediate-intensity anticoagulation in critically ill patients.

Adam Cuker, Eric K Tseng, Robby Nieuwlaat, Pantep Angchaisuksiri, Clifton Blair, Kathryn Dane, Jennifer Davila, Maria T DeSancho, David Diuguid, Daniel O Griffin and 37 more

Erratum issuedOpen access · goldAbstract readPractice Guideline
PubMed Full text at PMC Publisher
In one paragraph

Guideline in Blood advances, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 36 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
36citing papers in PubMed, 4 pooled it
11.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

36 citing papers in PubMed, 4 syntheses or guidelines pooled it, 67 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Pooled it
  4. Guideline
  5. Article
  6. Deep Vein Thrombosis in Critically Ill Patients With COVID-19 Pneumonia: Incidence, Wells Score Diagnostic Performance, and Hospital Prognosis.Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine · 2026
    Observational
  7. Article
  8. Article
  9. Article
  10. Article
  11. Review
  12. Review
  13. Article
  14. Article
  15. Cerebrovascular Manifestations of SARS-CoV-2: A Comprehensive Review.Current treatment options in neurology · 2023
    Review
  16. Article
  17. Review
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

47 authors at 20 institutions in 10 countries.

Adam CukerDepartment of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.ORCID 0000-0002-3595-5697
Eric K TsengSt. Michael's Hospital, Division of Hematology/Oncology, University of Toronto, Toronto, ON, Canada.ORCID 0000-0003-2745-8057
Robby NieuwlaatMichael G. DeGroote Cochrane Canada, McGRADE Centre, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Pantep AngchaisuksiriDivision of Hematology, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Clifton BlairUnion, NJ.
Kathryn DaneDepartment of Pharmacy, The Johns Hopkins Hospital, Baltimore, MD.
Jennifer DavilaChildren's Hospital at Montefiore, Division of Pediatric Hematology, Oncology, and Cellular Therapies, Albert Einstein College of Medicine, Bronx, NY.
Maria T DeSanchoDivision of Hematology-Oncology, Department of Medicine, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY.
David DiuguidDepartment of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY.
Daniel O GriffinDepartment of Medicine, Division of Infectious Diseases, College of Physicians and Surgeons, Columbia University, New York, NY.ORCID 0000-0001-5853-6906
Susan R KahnDepartment of Medicine, McGill University, Montreal, QC, Canada.
Frederikus A KlokDepartment of Internal Medicine-Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands.ORCID 0000-0001-9961-0754
Alfred Ian LeeSection of Hematology, School of Medicine, Yale University, New Haven, CT.
Ignacio NeumannDepartment of Internal Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Ashok PaiDivision of Hematology and Oncology, Kaiser Permanente, Oakland/Richmond, CA.
Marc RighiniDivision of Angiology and Hemostasis, Faculty of Medicine, Geneva University Hospitals, University of Geneva, Geneva, Switzerland.
Kristen M SanfilippoDepartment of Medicine, Washington University School of Medicine St. Louis, St. Louis, MO.ORCID 0000-0002-0433-7845
Deborah SiegalDepartment of Medicine and the Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.ORCID 0000-0003-3806-3245
Mike SkaraCottage Grove, MN.
Deirdra R TerrellDepartment of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK.ORCID 0000-0003-0794-5851
Kamshad TouriToronto, ON, Canada.
Elie A AklDepartment of Internal Medicine, American University of Beirut, Beirut, Lebanon.ORCID 0000-0002-3444-8618
Imad Bou AklDepartment of Internal Medicine, American University of Beirut, Beirut, Lebanon.
Antonio BognanniMichael G. DeGroote Cochrane Canada, McGRADE Centre, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.ORCID 0000-0003-0128-903X
Mary BoulosMichael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.ORCID 0000-0001-5046-598X
Romina Brignardello-PetersenMichael G. DeGroote Cochrane Canada, McGRADE Centre, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.ORCID 0000-0002-6010-9900
Rana CharideClinical Research Institute, American University of Beirut, Beirut, Lebanon.
Matthew ChanDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Karin DearnessLibrary Services, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.ORCID 0000-0002-6854-0156
Andrea J DarziMichael G. DeGroote Cochrane Canada, McGRADE Centre, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.ORCID 0000-0002-2498-1697
Philipp KolbMichael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
Luis E Colunga-LozanoDepartment of Clinical Medicine, Health Science Center, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico.ORCID 0000-0001-7737-4914
Razan MansourOffice of Scientific Affairs and Research, King Hussein Cancer Center, Amman, Jordan.ORCID 0000-0002-7719-9068
Gian Paolo MorganoMichael G. DeGroote Cochrane Canada, McGRADE Centre, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.ORCID 0000-0001-7577-7963
Rami Z MorsiDepartment of Neurology, University of Chicago, Chicago, IL.ORCID 0000-0003-2131-3711
Giovanna Muti-SchünemannMichael G. DeGroote Cochrane Canada, McGRADE Centre, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Atefeh NooriMichael G. DeGroote Cochrane Canada, McGRADE Centre, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.ORCID 0000-0002-0141-3718
Binu A PhilipMichael G. DeGroote Cochrane Canada, McGRADE Centre, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Thomas PiggottMichael G. DeGroote Cochrane Canada, McGRADE Centre, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.ORCID 0000-0003-1643-5386
Yuan QiuMichael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.ORCID 0000-0002-9572-9106
Yetiani RoldanMichael G. DeGroote Cochrane Canada, McGRADE Centre, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Finn SchünemannMedizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Germany.
Adrienne StevensMichael G. DeGroote Cochrane Canada, McGRADE Centre, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.ORCID 0000-0002-6257-4806
Karla SoloMichael G. DeGroote Cochrane Canada, McGRADE Centre, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.ORCID 0000-0001-6134-9140
Wojtek WierciochMichael G. DeGroote Cochrane Canada, McGRADE Centre, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.ORCID 0000-0001-6576-1650
Reem A MustafaMichael G. DeGroote Cochrane Canada, McGRADE Centre, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.ORCID 0000-0002-2091-0875
Holger J SchünemannMichael G. DeGroote Cochrane Canada, McGRADE Centre, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.ORCID 0000-0003-3211-8479
Cochrane · CAMcMaster University · CAAmerican University of Beirut · LBUniversity of Freiburg · DEAlbert Einstein College of Medicine · USColumbia University · USCottage Grove Community Medical Center · USJohns Hopkins Hospital · USKaiser Permanente Oakland Medical Center · USKing Hussein Cancer Center · JOLeiden University Medical Center · NLMahidol University · THMcGill University · CANewYork–Presbyterian Hospital · USPontificia Universidad Católica de Chile · CLSt. Joseph’s Healthcare Hamilton · CASt. Michael's Hospital · CAUnitedHealth Group (United States) · USUniversidad de Guadalajara · MXUniversity of Chicago · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Life after Recovery in Adult Thrombotic Thrombocytopenic Purpura (TTP): Let's Hear It from the SurvivorsK01HL135466 · NHLBI · UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR · PI TERRELL, DEIRDRA R · 2017 to 2021
$687k
NCATS NIH HHS UL1 TR001863NHLBI NIH HHS K01 HL135466
6 · The paper itself

Abstract

backgroundCOVID-19-related critical illness is associated with an increased risk of venous thromboembolism (VTE).

objectiveThese evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in making decisions about the use of anticoagulation for thromboprophylaxis in patients with COVID-19-related critical illness who do not have confirmed or suspected VTE.

methodsASH formed a multidisciplinary guideline panel that included 3 patient representatives and applied strategies to minimize potential bias from conflicts of interest. The McMaster University Grading of Recommendations Assessment, Development and Evaluation (GRADE) Centre supported the guideline development process by performing systematic evidence reviews (up to 5 March 2021). The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The panel used the GRADE approach to assess evidence and make recommendations, which were subject to public comment. This is an update on guidelines published in February 2021.

resultsThe panel agreed on 1 additional recommendation. The panel issued a conditional recommendation in favor of prophylactic-intensity over intermediate-intensity anticoagulation in patients with COVID-19-related critical illness who do not have confirmed or suspected VTE.

conclusionsThis recommendation was based on low certainty in the evidence, which underscores the need for additional high-quality, randomized, controlled trials comparing different intensities of anticoagulation in critically ill patients. Other key research priorities include better evidence regarding predictors of thrombosis and bleeding risk in critically ill patients with COVID-19 and the impact of nonanticoagulant therapies (eg, antiviral agents, corticosteroids) on thrombotic risk.

Indexed as

COVID-19HematologyVenous ThromboembolismAnticoagulantsCritical IllnessEvidence-Based MedicineHumansSARS-CoV-2United StatesAnticoagulants

Identifiers

PMID34474482
PMCPMC8416320
OpenAlexW3197892791

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.