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COVID-19 Pandemic and Thalassemia Major Patients: Transfusion Practice and Treatment Assessment
Yesim Oymak1, Tuba H Karapinar
1Department of Pediatric Hematology and Oncology, SBU. Izmir Dr Behcet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir, Turkey.
Insights
During the COVID-19 pandemic, blood transfusions for thalassemia major (TM) patients were maintained, though serum ferritin levels rose, necessitating meticulous chelation therapy. Healthcare systems must prepare for future transfusion challenges.
Area of Science:
- Hematology
- Transfusion Medicine
- Public Health
Background:
- The COVID-19 pandemic significantly reduced blood donations globally.
- Thalassemia major (TM) patients require regular blood transfusions for survival.
- Disruptions in blood supply and patient access to care posed risks to TM management during the pandemic.
Purpose of the Study:
- To assess the impact of the COVID-19 pandemic on the follow-up and treatment of patients with thalassemia major.
- To investigate changes in transfusion parameters and patient outcomes during the pandemic.
Main Methods:
- A cohort of 61 thalassemia major patients with no COVID-19 exposure were studied.
- Demographic data, transfusion volumes, pretransfusion hemoglobin, serum ferritin levels, and transfusion intervals were recorded.
- Data from before and during the pandemic were compared using statistical analysis.
Main Results:
- Mean pretransfusion hemoglobin levels slightly decreased during the pandemic (9.14 vs. 8.87 g/dL, P=0.023).
- Transfusion intervals and volumes remained consistent.
- Serum ferritin levels increased in 16.6% of patients, exceeding 1000 ng/mL.
Conclusions:
- Despite decreased blood donations, essential transfusion needs for TM patients were met.
- Elevated serum ferritin levels highlight the need for vigilant chelation therapy management.
- Healthcare providers must anticipate and prepare for potential transfusion practice challenges during future pandemics.
Background:
When the COVID-19 epidemic occurred for the first time in December 2019, the governments worldwide took some restriction measures for slowing the spread of novel coronavirus. Eventually, there was a considerable decrease in volunteer blood donations. Regular transfusions and follow-up of patients with thalassemia major (TM) should be maintained during this period. It is possible that the treatment of the patients with TM may hinder due to the difficulty of reaching the treatment center and the difficulty of blood supply. Thus, in this study, we aimed to investigate whether there were any differences in the follow-up and treatment of the patients with TM during the outbreak.
Materials And Methods:
Sixty-one patients with TM who were followed up in our center without COVID-19 contact history and symptoms were included in this study. The demographic features and red blood cell volume per kilogram they received, pretransfusion hemoglobin, serum ferritin (SF) level, biochemical parameters, and transfusion interval were recorded. The difference between the arithmetic mean of the data before and during the pandemic was evaluated.
Results:
In this study, 61 patients with TM (32 males/29 females, mean age 13.9±6.8 y) were evaluated. The mean pretransfusion hemoglobin value was 9.14±0.77 g/dL and 8.87± 0.80 g/dL before and during the pandemic, respectively (P=0.023). There was no difference between before and during the pandemic concerning transfusion interval and transfusion volume. However, SF levels increased above 1000 ng/mL in 16.6% of patients.
Conclusion:
Although blood donation decreased significantly during the pandemic, it was observed in this study that the blood needs of patients with TM could be provided. The results of the SF level showed that the management of chelation therapy should be more meticulous. However, we should be ready for the challenges in the transfusion practice of patients with TM due to fluctuations in the COVID-19 pandemic.
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