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:	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, Sergi Bellmunt-Montoya, Manuel Monreal, David Jiménez, on behalf of the COVILAX Project
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	venous thromboembolic disease COVID-19 coronavirus pulmonary embolism deep vein thrombosis anticoagulation Microbiology QR1-502
Acceso en línea:	https://doaj.org/article/248f349217204683a5cbf63ef1fce525
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spelling	oai:doaj.org-article:248f349217204683a5cbf63ef1fce5252021-11-25T19:12:31ZPICO Questions and DELPHI Methodology for the Management of Venous Thromboembolism Associated with COVID-1910.3390/v131121281999-4915https://doaj.org/article/248f349217204683a5cbf63ef1fce5252021-10-01T00:00:00Zhttps://www.mdpi.com/1999-4915/13/11/2128https://doaj.org/toc/1999-4915Patients 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.Antoni Riera-MestreLuis Jara-PalomaresRamón LecumberriJavier Trujillo-SantosEnric GrauAngeles Blanco-MolinaAna Piera CarbonellSonia JiménezManuel Frías VargasMari Paz FusetSergi Bellmunt-MontoyaManuel MonrealDavid Jiménezon behalf of the COVILAX ProjectMDPI AGarticlevenous thromboembolic diseaseCOVID-19coronaviruspulmonary embolismdeep vein thrombosisanticoagulationMicrobiologyQR1-502ENViruses, Vol 13, Iss 2128, p 2128 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	venous thromboembolic disease COVID-19 coronavirus pulmonary embolism deep vein thrombosis anticoagulation Microbiology QR1-502
spellingShingle	venous thromboembolic disease COVID-19 coronavirus pulmonary embolism deep vein thrombosis anticoagulation Microbiology QR1-502 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 Sergi Bellmunt-Montoya Manuel Monreal David Jiménez on behalf of the COVILAX Project PICO Questions and DELPHI Methodology for the Management of Venous Thromboembolism Associated with COVID-19
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	article
author	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 Sergi Bellmunt-Montoya Manuel Monreal David Jiménez on behalf of the COVILAX Project
author_facet	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 Sergi Bellmunt-Montoya Manuel Monreal David Jiménez on behalf of the COVILAX Project
author_sort	Antoni Riera-Mestre
title	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_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_sort	pico questions and delphi methodology for the management of venous thromboembolism associated with covid-19
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/248f349217204683a5cbf63ef1fce525
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PICO Questions and DELPHI Methodology for the Management of Venous Thromboembolism Associated with COVID-19

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