Blood use and transfusion needs at a large health care system in Washington state during the SARS‐CoV‐2 pandemic

Abstract

Background: This report evaluates hospital blood use trends during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, and identifies factors associated with the need for transfusion and risk of death in patients with coronavirus 2019 (COVID-19). Methods: Overall hospital blood use and medical records of adult patients with COVID-19 were extracted for two institutions. Multivariate logistic regression models were conducted to estimate associations between the outcomes transfusion and mortality and patient factors. Results: Daily blood use decreased compared to pre-COVID-19 levels; the effect was more significant for platelets (29% and 34%) compared to red blood cells (25% and 20%) at the two institutions, respectively. Surgical and oncologic services had a decrease in average daily use of platelets of 52% and 30%, and red blood cells of 39% and 25%, respectively. A total of 128 patients with COVID-19 were hospitalized, and 13 (10%) received at least one transfusion due to anemia secondary to chronic illness (n = 7), recent surgery (n = 3), and extracorporeal membrane oxygenation (n = 3). Lower baseline platelet count and admission to the intensive care unit were associated with increased risk of transfusion. The blood group distribution in patients with COVID-19 was 37% group O, 40% group A, 18% group B, and 5% group AB. Non-type O was not associated with increased risk of mortality. Conclusion: The response to the SARS-CoV-2 pandemic included changes in routine hospital operations that allowed for the provision of a sufficient level of care for patients with and without COVID-19. Although blood type may play a role in COVID-19 susceptibility, it did not seem to be associated with patient mortality.

National level adjustments to the challenges of the SARS‐CoV2 pandemic on blood banking operations

“…As a result of the spring lockdown lasting for 7 weeks, the output of this mode of donor drives declined by an average of 50% (range: 35%–61%). This reaction was also observed in several other countries 6,7,18,20 . The swing‐back of field donation activity was only partial in terms of number of field events (Figure 1(B) solid lines), however, event‐efficiency improved substantially with a total number of field donations close to our comparator value (Figure 1(A) middle curves).…”

“…Similar trends have recently been described by others with reporting weekly hospital blood product utilization between the middle of February through the end of April 2020 in the Seattle area. There, more profound declines in PLT use were found compared to RBC, however, their comparator was less clearly defined 20 . In another report, an overall fall of 42% in daily transfusions was documented in the Baltimore area in March and April of 2020 and returning to normal in May but without comparing to similar unaltered time periods 22 .…”

Blood component utilization in COVID‐19 patients in New York City: Transfusions do not follow the curve

“…Our centers offer both adult and pediatric ECMO services, and ECMO use has been previously associated with blood product transfusions at other centers offering it, in particular RBCs and cryoprecipitate. 10,13 In one of these studies, 3 out of 128 (2.4%) COVID-19 inpatients required ECMO and all received transfusions. Communication and flexibility with our blood suppliers was critical to avoiding additional inventory shortages; during the peak of the pandemic, we communicated with our blood suppliers daily to inform them of our inventory needs and for them to update us on their available supply.…”

How should we use convalescent plasma therapies for the management of COVID-19?

“…This can be very challenging at times when measures to contain an infectious outbreak substantially affect blood center operations and efforts to maintain sufficiency in other blood products. [52][53][54][55] Logistical issues such as delays in access to CP for clinical trials have been reported. 54,55 Conclusions CP may be of benefit for COVID-19, but more information on both efficacy and safety is needed.…”