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Table 2 Major societal recommendations regarding using biomarkers to guide anticoagulation

From: Comparison of published guidelines for management of coagulopathy and thrombosis in critically ill patients with COVID 19: implications for clinical practice and future investigations

Biomarkers to guide anticoagulation

CDC

Insufficient data to recommend for or against using hematologic and coagulation parameters to guide management decisions.

ISTH-IG

Not mentioned

ACF

Biomarker thresholds such as D-dimer for guiding anticoagulation management should not be done outside the setting of a clinical trial.

ASH

No particular change to regimen recommended for patients with lupus like inhibitors. TEG and ROTEM should not be used routinely to guide management.

ACCP

Not mentioned

SSC-ISTH

D-dimer levels should not be used solely to guide anticoagulation regimens.

ACC

Further investigation is required to determine the role of antiphospholipid antibodies in pathophysiology of COVID-19-associated thrombosis. D-dimer > 2 times the upper limit may suggest that patient is at high risk for VTE and consideration of extended prophylaxis (up to 45 days) in patients at low risk of bleeding.

  1. Abbreviations: COVID-19 coronavirus disease 2019, ROTEM rotational thromboelastometry, TEG thromboelastography, VTE venous thromboembolism