Blood component use in critical care in patients with COVID‐19 infection: a single‐centre experience

Abstract

Summary There has been a significant surge in admissions to critical care during the coronavirus disease 2019 (COVID‐19) pandemic. At present, the demands on blood components have not been described. We reviewed their use during the first 6 weeks of the outbreak from 3 March 2020 in a tertiary‐level critical care department providing venovenous extracorporeal membrane oxygenation (vv‐ECMO). A total of 265 patients were reviewed, with 235 not requiring ECMO and 30 requiring vv‐ECMO. In total, 50 patients required blood components during their critical care admission. Red cell concentrates were the most frequently transfused component in COVID‐19‐infected patients with higher rates of use during vv‐ECMO. The use of fresh frozen plasma, cryoprecipitate and platelet transfusions was low in a period prior to the use of convalescent plasma.

Outcomes and risk factors for the survival of COVID-19 related ARDS patients treated with extracorporeal membrane oxygenation

“…ECMO related anemia and coagulopathy led to 100% blood transfusion in our ECMO group to maintain hemoglobin levels above 70 g/L and relatively normal coagulation parameters. We noticed that red cell concentrates were the most frequently transfused component in COVID-19 patients on ECMO, which was also reported by other teams [26,27]. Fresh frozen plasma, cryoprecipitate and platelet transfusions were used to balance the coagulation system.…”

COVID-19: risk of infection is high, independently of ABO blood group

“…Less than 20% of patients with COVID-19 received blood transfusions. [19][20][21] The details of ABO matching can easily be reported, 22 as they are routinely known. When properly documented, the combined data from small prospective observational studies can amount to impressive case series.…”

COVID‐19 insights from transfusion medicine

“…Which comorbidities are predisposing to blood transfusion and severity of viral disease? This short report from critical care at a large academic centre in London, UK 6 may not be representative of general clinical settings in primary care hospitals. Hence, more such descriptions of transfusion requirements could be informative, which will eventually allow us to compare the practice among patient cohorts in different countries.…”

“…For the patients who did require transfusion, the component types and clinical indications remained to be discerned. In this issue, Doyle et al 6 . describe transfusion practice for patients with COVID‐19 in intensive care units (ICUs), some requiring extracorporeal membrane oxygenation (ECMO), as one of the first reports on this topic.…”

“…And blood usage seemed almost restricted to red cell components. During ECMO, the red cell usage in patients with COVID‐19 6 resembled usage in patients without COVID‐19 7 . The indications for transfusion in patients without ECMO should be described in greater detail in future studies.…”