Evidence map›Paper›PMID 34834935›Full record

ArticleViruses2021

PICO Questions and DELPHI Methodology for the Management of Venous Thromboembolism Associated with COVID-19.

Antoni Riera-Mestre, Luis Jara-Palomares, Ramón Lecumberri, Javier Trujillo-Santos, Enric Grau, Angeles Blanco-Molina, Ana Piera Carbonell, Sonia Jiménez, Manuel Frías Vargas, Mari Paz Fuset and 4 more

Open access · goldAbstract read
In one paragraph

Article in Viruses, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 18% 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 9 institutions in 1 country.

Antoni Riera-MestreInternal Medicine Department, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), 08907 Barcelona, Spain.ORCID 0000-0001-9411-804X
Luis Jara-PalomaresMedical-Surgical Unit for Respiratory Diseases, Virgen del Rocío University Hospital, 28029 Sevilla, Spain.ORCID 0000-0002-4125-3376
Ramón LecumberriHematology Department, Clínica Universidad de Navarra, 31008 Pamplona, Spain.ORCID 0000-0002-8850-8866
Javier Trujillo-SantosInternal Medicine Department, Hospital General Universitario Santa Lucía, 30204 Cartagena, Spain.ORCID 0000-0003-0861-9927
Enric GrauHematology Department, Lluis Alcanyis de Xativa Hospital, 46800 Valencia, Spain.
Angeles Blanco-MolinaInternal Medicine Unit, Hospital Universitario Reina Sofía, 10004 Córdoba, Spain.
Ana Piera CarbonellLuanco Health Center, 33440 Gozón, Spain.ORCID 0000-0003-3948-0833
Sonia JiménezEmergency Area, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain.
Manuel Frías VargasComillas Health Center, 28019 Madrid, Spain.
Mari Paz FusetIntensive Medicine Department, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), 08907 Barcelona, Spain.
Sergi Bellmunt-MontoyaAngiology and Vascular Surgery Department, Hospital Universitari Vall d'Hebron, 08035 Barcelona, Spain.ORCID 0000-0002-2851-720X
Manuel MonrealFaculty of Health Sciences, Universidad Católica San Antonio de Murcia (UCAM), 30107 Murcia, Spain.ORCID 0000-0002-0494-0767
David JiménezCenter for Biomedical Research in Respiratory Diseases Network (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain.ORCID 0000-0002-4571-7721
On Behalf Of The Covilax Project
Bellvitge University Hospital · ESInstituto de Salud Carlos III · ESConsorci Institut D'Investigacions Biomediques August Pi I Sunyer · ESHospital Universitari Germans Trias i Pujol · ESHospital Universitario Lluís Alcanyís · ESHospital Universitario Reina Sofía · ESSanta Lucía University General Hospital · ESUniversidad de Alcalá · ESUniversitat Autònoma de Barcelona · ES

Funding

Sanofi (Spain) 2021
6 · The paper itself

Abstract

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.

Indexed as

AnticoagulantsCOVID-19Delphi TechniqueDuration of TherapyHeparin, Low-Molecular-WeightHumansVenous ThromboembolismAnticoagulantsHeparin, Low-Molecular-WeightanticoagulationcoronavirusCOVID-19deep vein thrombosispulmonary embolismvenous thromboembolic disease

Identifiers

PMID34834935
PMCPMC8624706
OpenAlexW3209692500

What OpenQuestion holds

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LicenceCC BY
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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.