Impact of Covid-19 epidemic on the activities of a blood centre, transfusion support for infected patients and clinical outcomes.

ABSTRACT

OBJECTIVES: We evaluated how the Severe Acute Respiratory disease from Coronavirus 2 (SARS-CoV-2) epidemic impacted transfusion services, transfusion support required by Covid-19 patients and their clinical outcome. BACKGROUND: In Italy, the first confirmed case of SARS-CoV-2 infection was registered on 21 February 2020. As of 20 April, about 250 000 cases were registered, 1143 of which were in the province of Pescara. METHODS: We compared transfusion services provided by the blood centre of Pescara between 1 March and 20 April 2019 and between 1 March and 20 April 2020. We assessed the number and type of blood components donated, those transfused in the various hospital departments and those transfused to Covid-19 patients. RESULTS: Compared to 2019, we documented a decrease of 32% in the number of donations. The number of transfusions increased by 139% in the infectious diseases department (IDD), dedicated to Covid-19 patients, and by 76% in the intensive care unit (ICU), whereas it markedly decreased in the other departments. Of 299 patients with Covid-19, 60 were transfused (20.1%). Transfused patients in the ICU were significantly younger than those in IDD and had a lower number of lymphocytes, lower post-transfusion increment of haemoglobin levels and higher D-dimer and C reactive protein values. Mortality rate was 60.7% among transfused patients in the ICU and 39.0% among those in the IDD (p = 0.02). CONCLUSION: The Covid-19 epidemic had a profound impact on transfusion activities. The important blood demand for Covid-19 patients was satisfied because of the reduction in activities in other hospital wards. Covid-19-positive transfused patients showed a very poor prognosis.