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

TitleBlood component utilization in COVID-19 patients in New York City: Transfusions do not follow the curve.
Publication TypeJournal Article
Year of Publication2021
AuthorsDeSimone RA, Costa VA, Kane K, Sepulveda JL, Ellsworth GB, Gulick RM, Zucker J, Sobieszcyk ME, Schwartz J, Cushing MM
JournalTransfusion
Volume61
Issue3
Pagination692-698
Date Published2021 03
ISSN1537-2995
KeywordsAdult, Aged, Aged, 80 and over, Blood Component Transfusion, COVID-19, COVID-19 Testing, Critical Illness, Facilities and Services Utilization, Female, Hospitalization, Humans, Linear Models, Male, Middle Aged, Needs Assessment, New York City, Pandemics, Retrospective Studies, Severity of Illness Index
Abstract

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 network's 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‚ÄČ041 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 patients' 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 patients' transfusion needs may increase over time. Daily or weekly trending of patients' clinical status and laboratory values may assist blood banks in inventory management.

DOI10.1111/trf.16202
Alternate JournalTransfusion
PubMed ID33215718
PubMed Central IDPMC7753518
Grant ListUL1 TR000457 / TR / NCATS NIH HHS / United States
UL1 TR002384 / TR / NCATS NIH HHS / United States
UM1 AI069470 / AI / NIAID NIH HHS / United States
Related Faculty: 
Melissa Cushing, M.D. Robert DeSimone, M.D.

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