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Blood component utilization in COVID‐19 patients in New York City: Transfusions do not follow the curve
Author(s) -
DeSimone Robert A.,
Costa Victoria A.,
Kane Kathleen,
Sepulveda Jorge L.,
Ellsworth Grant B.,
Gulick Roy M.,
Zucker Jason,
Sobieszcyk Magdalena E,
Schwartz Joseph,
Cushing Melissa M.
Publication year - 2021
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.16202
Subject(s) - medicine , blood product , pandemic , covid-19 , partial thromboplastin time , emergency medicine , blood transfusion , intensive care medicine , platelet , surgery , disease , infectious disease (medical specialty)
Background Blood suppliers and transfusion services have worked diligently to maintain an adequate blood supply during the COVID‐19 pandemic. Our experience has shown that some COVID‐19 inpatients require transfusion support; understanding this need is critical to blood product inventory management. Study Design and Methods Hospital‐wide and COVID‐19 specific inpatient blood product utilization data were collected retrospectively for our networkʼs two tertiary academic medical centers over a 9‐week period (March 1, 2020‐May 2, 2020), when most inpatients had COVID‐19. Utilization data were merged with a COVID‐19 patient database to investigate clinical demographic characteristics of transfused COVID‐19 inpatients relative to non‐transfused ones. Results Overall, 11 041 COVID‐19 patients were admitted and 364 received blood product transfusions for an overall transfusion rate of 3.3%. COVID‐19 patients received 1746 blood components in total, the majority of which were red blood cells. COVID‐19 patientsʼ weekly transfusion rate increased as the pandemic progressed, possibly reflecting their increased severity of illness. Transfusion was significantly associated with several indicators of severe disease, including mortality, intubation, thrombosis, longer hospital admission, lower hemoglobin and platelet nadirs, and longer prothrombin and activated partial thromboplastin times. As the pandemic progressed, institutional adherence to transfusion guidelines improved for RBC transfusions compared to prior year trends but did not improve for platelets or plasma. Conclusion There is a need to closely monitor the blood product inventory and demand throughout the COVID‐19 pandemic as patientsʼ transfusion needs may increase over time. Daily or weekly trending of patientsʼ clinical status and laboratory values may assist blood banks in inventory management.