ASH Suggests Not Using Outpatient Thromboprophylaxis for COVID-19

A new draft recommendation relating to anticoagulation for discharged patients with COVID-19 has been issued by the American Society of Hematology (ASH).

For patients with COVID-19 who are being discharged from the hospital and who do not have suspected or confirmed venous thromboembolism or another indication for anticoagulation, the ASH guideline panel suggests not using anticoagulant outpatient thromboprophylaxis (conditional recommendation based on very low-certainty evidence).

When deciding whether to use postdischarge thromboprophylaxis, an individualized assessment of the patient's risk for thrombosis and bleeding and shared decision-making are important. There are no validated risk assessment models for estimating thrombotic and bleeding risk for COVID-19 patients after discharge.

For patients judged to be at high thrombotic risk and low bleeding risk, the panel acknowledges that postdischarge thromboprophylaxis may be reasonable.

The recommendation is available for public comment, open to all ASH members and the public.