No abstract

Background Blood transfusion is a life-saving procedure, but may cause adverse transfusion reactions (TRs). The reporting of TRs is often missed due to various reasons. The aim of this study was to determine the incidence of unreported acute TRs through active surveillance and to compare it with the incidence of passively reported TRs. Methods This prospective observational study was done over a period of four months at a tertiary care hospital. A total of 500 consecutive transfusion episodes (TEs) in patients who had received blood component transfusions in the intensive care units were included in the study. Comprehensive data were collected from the blood bank records, patient records and through interviews with the attending clinical staff. The TEs were defined as all blood components issued to a single patient in 24 h. Results The overall incidence of TRs was 1.8 % (9 cases), with 0.4 % (2 cases) being reported passively, while 1.4 % (7 cases) were identified during active surveillance. The transfusion-associated cardiac overload (TACO) had the highest incidence of 1.2 % (6 cases) in active surveillance. A single case of acute hemolytic transfusion reaction was also observed during active surveillance. The passively reported TRs were one allergic reaction and one febrile non-hemolytic transfusion reaction. Conclusion Active surveillance of TRs provided an insight into the true incidence of TRs, which is higher when compared with the passively reported TRs. The TACO was found to have the highest incidence and not a single case was reported. There is a need to improve awareness regarding TR reporting.

<p class="abstract">Coronavirus disease 2019 (COVID-19) is a threat to the global health caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The lungs are the primary site of infection in COVID-19 patient and the symptoms ranges from mild flu like manifestations to fulminant pneumonia and respiratory failure. COVID-19 infection also significantly affects the oral cavity and salivary glands with oral mucosal manifestations. Other than airway manifestations, COVID-19 patients are presenting with oral cavity lesions such as aphthous like ulcers, glossitis, oral mucositis or stomatitis, oral candidiasis and herpetic recurrences. These oral lesions are often associated with immunocompromised patients and elderly age. Direct involvement of the SARS-CoV-2 virus for development of oral ulcers remains uncertain. The salivary gland related symptoms and taste disturbances are highly common in COVID-19 patients. In COVID-19 patient, certain presentations like ulcers or blisters or diffuse reddish lesions affect both keratinized and non-keratinized tissues of the oral cavity. These lesions are found in palate, lip mucosa, buccal mucosa and tongue. The ulceration and blisters of the oral cavity are more often seen. There is still a gap of knowledge related to the oral manifestations of the COVID-19 infections and its impact on the oral cavity. This review article discussed the details of the oral cavity lesions in COVID-19 patients.</p>

Background and Objectives Blood donor deferral is an essential tool for blood safety. The ongoing COVID‐19 pandemic has adversely affected blood transfusion services all over the world. But its impact on donor deferral rate and the pattern is unclear in light of the new donor deferral policy due to the COVID‐19 pandemic. Materials and Methods This retrospective study was divided into pre‐COVID and COVID (15 March 2019–14 March 2021). All the deferred donors were divided into six different categories: (1) medical causes, (2) surgical causes, (3) drugs and vaccination, (4) risk of transfusion‐transmitted diseases, (5) miscellaneous causes and (6) flu‐like symptoms. In addition, COVID‐related deferrals were also incorporated. All these above categories along with the donor demography were analysed by SPSS software version 25. Results The donor deferral rate was 17.03% and 12.74% during the pre‐COVID and COVID periods, respectively. During the pre‐COVID period, Category 3 deferrals and during COVID period, Category 6 deferrals were significantly higher. A reversal in pattern with increased blood pressure (40.2% vs. 24.04%) over‐riding low haemoglobin (34.77% vs. 55.5%) was noted in the Category 1 deferral during the COVID period. Category 1 deferral was more in middle‐aged adults as compared to young and old adults (p < 0.05). Among middle‐aged adults, deferral due to flu‐like symptoms was also significantly more during the COVID period (p < 0.05). Conclusion COVID‐19 significantly affected the donor pool and changed the pattern of donor deferral. Understanding donor deferral patterns may help in identifying targeted donor populations and planning donor recruitment strategies in future pandemic crises.

Background and Objectives Therapeutic plasma exchange (TPE) has been used in severe COVID‐19 disease to eliminate the cytokine storm. This meta‐analysis aims to assess the effectiveness of TPE in reducing mortality in severe COVID‐19 disease compared to standard treatment. Materials and Methods A comprehensive literature search was performed in PubMed, the Cochrane database and the International Clinical Trial Registry Platform (ICTRP). The random‐effect model was used to calculate the risk ratio and standardized mean difference (SMD) as pooled effect size for the difference in mortality and length of the intensive care unit (ICU) stay. The risk of bias and publication bias were assessed in R version 4.1.0. The certainty of the evidence was calculated using the GradePro tool. Results The database identified 382 participants from six studies, including one randomized control trial. Egger's test did not detect any publication bias (p = 0.178). The random model analysis for mortality evaluated a risk ratio of 0.38 (95% CI: 0.28–0.52) with a significant reduction in the TPE group. The certainty of the evidence was moderate, with a risk ratio of 0.34 (95% CI: 0.24–0.49). Length of ICU stays between TPE versus standard care showed an SMD of 0.08 (95% CI: −0.38, 0.55) and was not significant. Conclusion The length of ICU stay in the TPE group was not different from standard care. However, this meta‐analysis revealed a significant benefit of TPE in reducing mortality in severe COVID‐19 disease compared to standard treatment.