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Impact of COVID-19 and lockdown regarding blood transfusion
Xavier Delabranche1, Daniel Kientz2, Charles Tacquard1,2
1Anaesthesia, Intensive Care and Perioperative Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France.
Insights
The COVID-19 pandemic moderately decreased blood transfusions despite reduced hospital activity. Blood donation also declined, but blood stocks remained stable, preventing transfusion restrictions.
Area of Science:
- Hematology
- Transfusion Medicine
- Infectious Diseases
Background:
- The SARS-CoV-2 pandemic caused significant hospital influx, challenging blood transfusion services.
- Managing blood bank safety, collection, stocks, and patient demand (including COVID-19 specific needs) became critical.
- Potential blood transfusion restrictions were considered due to anticipated stock limitations.
Purpose of the Study:
- To analyze blood transfusion practices and blood collection during the early COVID-19 pandemic.
- To assess the impact of reduced hospital activity and donation changes on blood supply and demand.
Main Methods:
- Retrospective analysis of blood transfusions at a tertiary hospital.
- Examination of blood collection data from the referring blood bank.
- Study period: February 24 to May 31, 2020.
Main Results:
- Global hospital activity decreased by 33%, while blood transfusions reduced by only 17%.
- 10.3% of COVID-19 patients required transfusion; 2.0% had acute bleeding.
- Blood donation dropped by 11% due to cancelled mobile collections, but overall blood stocks slightly increased.
Conclusions:
- The COVID-19 pandemic led to a moderate decrease in blood transfusion demand.
- Despite reduced donations, blood stocks remained adequate, and no transfusion restrictions were needed.
- Essential transfusions for urgent cases, bleeding, and supportive care continued without interruption.
Background:
The outbreak of a SARS-CoV-2 resulted in a massive afflux of patients in hospital and intensive care units with many challenges. Blood transfusion was one of them regarding both blood banks (safety, collection, and stocks) and consumption (usual care and unknown specific demand of COVID-19 patients). The risk of mismatch was sufficient to plan blood transfusion restrictions if stocks became limited.
Study Design And Methods:
Analyses of blood transfusion in a tertiary hospital and blood collection in the referring blood bank between February 24 and May 31, 2020.
Results:
Withdrawal of elective surgery and non-urgent care and admission of 2291 COVID-19 patients reduced global activity by 33% but transfusion by 17% only. Only 237 (10.3) % of COVID-19 patients required blood transfusion, including 45 (2.0%) with acute bleeding. Lockdown and cancellation of mobile collection resulted in an 11% reduction in blood donation compared to 2019. The ratio of reduction in blood transfusion to blood donation remained positive and stocks were slightly enhanced.
Discussion:
Reduction of admissions due to SARS-CoV-2 pandemic results only in a moderate decrease of blood transfusion. Incompressible blood transfusions concern urgent surgery, acute bleeding (including some patients with COVID-19, especially under high anticoagulation), or are supportive for chemotherapy-induced aplasia or chronic anemia. Lockdown results in a decrease of blood donation by cancellation of mobile donation but with little impact on a short period by mobilization of usual donors. No mismatch between demand and donation was evidenced and no planned restriction to blood transfusion was necessary.
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