ASH Issues Recommendation Regarding Anticoagulation Use in COVID-19

Evidence-based guideline suggests against anticoagulation after release from the hospital for most adult COVID-19 patients

(WASHINGTON, July 9, 2021) — Today, ASH released a new recommendation suggesting that adult patients who had been hospitalized for COVID-19 and did not develop blood clots should not receive anticoagulation upon discharge in most instances. The recommendation, the latest as part of the ASH guidelines on use of anticoagulation in patients with COVID-19, is intended to help hematologists, hospital-based clinicians, and patients as they make decisions about their care after hospitalization.

Abnormal blood clotting has been reported as a serious complication in patients with COVID-19, particularly hospitalized patients. ASH formed the guideline panel in Spring 2020 in recognition of the urgent public health need to issue clinical practice guidelines for the prevention of the complication. ASH previously issued recommendations for the use of anticoagulation in critically and acutely ill hospitalized patients with COVID-19.

In developing the new recommendation, the guideline panel considered evidence from observational studies suggesting that the benefits of using anticoagulation after discharge did not outweigh the potential harms, including the bleeding risks associated with taking the medicine and the cost of treatment. The panel also wrote that it remains important for clinicians to evaluate each patient individually, and to consider using post-discharge anticoagulation for patients at high risk for clots and low risk for bleeding.

“The mission of our guideline panel since it was formed has been to continually evaluate emerging data to address questions of anticoagulation – should we be using it, and at what dose – to prevent blood clots,” said Adam Cuker, MD, co-chair of the guideline panel and Associate Professor of Medicine at the University of Pennsylvania. “This recommendation focuses on how we should treat patients who are recovering from COVID-19 and are able to leave the hospital. Early in the pandemic when we were all scrambling to get a handle on this disease, many institutions adopted the practice of routinely using anticoagulation for patients after discharge. But the evidence we have now suggests against using anticoagulation in most instances.”

The new recommendation will be posted online and undergo an open public comment period before being submitted for peer review and publication in Blood Advances. The evidence supporting the recommendation will be maintained through living systematic reviews and updated as needed.

Additional Information:

The American Society of Hematology (ASH) (www.hematology.org) is the world’s largest professional society of hematologists dedicated to furthering the understanding, diagnosis, treatment, and prevention of disorders affecting the blood. For 60 years, the Society has led the development of hematology as a discipline by promoting research, patient care, education, training, and advocacy in hematology. ASH publishes Blood (www.bloodjournal.org), the most cited peer-reviewed publication in the field, which is available weekly in print and online. In 2016, ASH launched Blood Advances (www.bloodadvances.org), an online, peer-reviewed open-access journal.

Contact:
Leah Enser, American Society of Hematology
lenser@hematology.org; 202-552-4927