In another comment published in Lancet Hematology, a team of researchers on behalf of the National Clinical Research Centre for Respiratory Disease at the First Affiliated Hospital of Guangzhou Medical University in China, collected data from patients with confirmed COVID-19 to assess the risk for VTE in this population.3
“Among patients with COVID-19, especially those who are severely and critically ill, a variety of potential risk factors for venous thromboembolism exist,” the researchers wrote.
The authors also noted that assessing VTE and bleeding risks regularly is essential because “patients with COVID-19 can rapidly develop severe of critical disease, causing a series of complications such as renal failure, respiratory failure, or liver dysfunction, which can affect both [VTE] and bleeding status.”
The investigators of the retrospective analysis concluded they “found that patients with COVID-19 with a high risk of [VTE] had poorer outcomes than patients with a low risk, suggesting that these patients might require increased attention in case of rapid deterioration.”
In light of the increased association between COVID-19 and coagulopathy in this patient group, the American Society of Hematology (ASH) published a press release on May 12, 2020, indicating that they will be developing clinical practice guidelines to help guide clinicians on the use of anticoagulants in patients with COVID-19.4
The guidelines will address 4 groups of patients with COVID-19:
- Acutely ill hospitalized patients
- Critically ill hospitalized patients
- Post-hospital discharge patients
- Nonhospitalized patients
ASH President Stephanie Lee, MD, of the Fred Hutchinson Cancer Research Center in Seattle, Washington, stated in the press release that “there is an urgent and critical need to provide guidance based on the best available evidence for those treating patients with this disease, recognizing also that there are different methods of anticoagulation and risks.”
The guidelines will be created by a panel of multidisciplinary, international representatives and developed based on currently available studies and early reports from observational studies. The guidelines are expected to be released later this year and will be updated as new evidence-supported information is available.
- Levi M, Thachil J, Iba T, Levy JH. Coagulation abnormalities and thrombosis in patients with COVID-19 [published online May 11, 2020]. Lancet Haematol. doi: 10.1016/s2352-3026(20)30145-9
- Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18:844-847.
- Wang T, Chen R, Liu C, et al. Attention should be paid to venous thromboembolism prophylaxis in the management of COVID-19 [published online April 9, 2020]. Lancet Haematol. doi: 10.1016/s2352-3026(20)30109-5
- ASH to develop clinical practice guidelines on the use of anticoagulation in patients with COVID-19 [press release]. Washington, DC: American Society of Hematology. May 12, 2020.