Blood transfusion in COVID-19 hospital

ABSTRACT

Background: The novel coronavirus disease 2019 (COVID-19) has caused a sudden and unexpected rise in hospitalizations and deaths around the world. Many hospitals have changed their daily work and become infectious. A reduction in blood collection of 10 to 50% has been reported. In Russia, in 2020, compared to 2019, blood collection decreased by 4%. Data on the use of blood products by patients with COVID-19 is very limited and highly variable. According to various sources, from 3.3 to 13.4% of patients with COVID-19 need a blood transfusion. In different hospitals transferred to the COVID-19 mode, blood transfusion changes in different ways somewhere it increases, and somewhere it decreases. Aims: To identify the features of transfusion therapy in the COVID- 19 hospital of the Pirogov Center. Methods: We studied the structure of recipients and blood transfusions in the COVID-19 hospital and other departments of the Pirogov Center in 2020. We transfused leucodepleted red blood cells in PAGGS-M, leucodepleted amotosalen/UVA pathogen inactivated platelets in SSP+ and methylene blue/white light pathogen inactivated male plasma. No COVID-19 convalescent plasma has been transfused. Results: Among the 1141 patients of the COVID-19 hospital, 61 patients (5.3%) and among 37,136 patients in other departments, 710 (1.9%) patients received transfusions of blood components. During the operation of the COVID-19 hospital, the Pirogov Center's need for donor blood components was fully met. In the COVID-19 hospital compared to other departments • the part of recipients of all blood components, red blood cells and plasma was higher (p < 0.01);• 4 units and 4-6 units of red blood cells were transfused more often (p < 0.01), more than 11 units of red blood cells were not transfused;• among recipients of red blood cells, the part of people over 60 years old is 42.4% higher than the same part among other patients (p < 0.01);• among plasma recipients, the part of persons under 45 years of age is significantly reduced (p < 0.05). Red blood cells transfusion helped to save most of the most severe patients • over 70 years old, • anaemia on admission, • the period of D-dimer concentration over 1.5 mg/l-more than 20 days, • concomitant oncological diseases-in 20% of patients. Among patients with new coronavirus infection and no indication for red blood cell transfusion, haemoglobin concentration negatively correlates with age and D-dimer level. The absence of such connections in red blood cells recipients indicates the importance of other factors (oncological process, bleeding) in the development of anaemia that requires transfusion correction. Summary/Conclusions: The data on the needs of patients in the COVID-19 hospital for transfusion therapy can be used as a benchmark for the related work planning.