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在 SARS-CoV-2 大流行期间,华盛顿州一个大型医疗保健系统的血液使用和输血需求。

Blood use and transfusion needs at a large health care system in Washington state during the SARS-CoV-2 pandemic.

机构信息

Transfusion Medicine Division, Laboratory Medicine, University of Washington, Seattle, Washington, USA.

Hematology Division, Medicine, University of Washington, Seattle, Washington, USA.

出版信息

Transfusion. 2020 Dec;60(12):2859-2866. doi: 10.1111/trf.16051. Epub 2020 Aug 28.

Abstract

BACKGROUND

This report evaluates hospital blood use trends during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, and identifies factors associated with the need for transfusion and risk of death in patients with coronavirus 2019 (COVID-19).

METHODS

Overall hospital blood use and medical records of adult patients with COVID-19 were extracted for two institutions. Multivariate logistic regression models were conducted to estimate associations between the outcomes transfusion and mortality and patient factors.

RESULTS

Daily blood use decreased compared to pre-COVID-19 levels; the effect was more significant for platelets (29% and 34%) compared to red blood cells (25% and 20%) at the two institutions, respectively. Surgical and oncologic services had a decrease in average daily use of platelets of 52% and 30%, and red blood cells of 39% and 25%, respectively. A total of 128 patients with COVID-19 were hospitalized, and 13 (10%) received at least one transfusion due to anemia secondary to chronic illness (n = 7), recent surgery (n = 3), and extracorporeal membrane oxygenation (n = 3). Lower baseline platelet count and admission to the intensive care unit were associated with increased risk of transfusion. The blood group distribution in patients with COVID-19 was 37% group O, 40% group A, 18% group B, and 5% group AB. Non-type O was not associated with increased risk of mortality.

CONCLUSION

The response to the SARS-CoV-2 pandemic included changes in routine hospital operations that allowed for the provision of a sufficient level of care for patients with and without COVID-19. Although blood type may play a role in COVID-19 susceptibility, it did not seem to be associated with patient mortality.

摘要

背景

本报告评估了严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)大流行期间医院的血液使用趋势,并确定了与 2019 年冠状病毒病(COVID-19)患者输血需求和死亡风险相关的因素。

方法

从两家医院提取了 COVID-19 成年患者的整体医院血液使用和病历。使用多变量逻辑回归模型来估计输血和死亡率与患者因素之间的关联。

结果

与 COVID-19 前水平相比,每日血液使用量下降;在这两个机构,血小板的降幅分别为 29%和 34%,红细胞的降幅分别为 25%和 20%,降幅更为显著。手术和肿瘤服务的血小板平均日用量分别下降了 52%和 30%,红细胞用量分别下降了 39%和 25%。共有 128 例 COVID-19 患者住院,由于慢性病(n=7)、近期手术(n=3)和体外膜氧合(n=3)导致贫血,有 13 例(10%)接受了至少一次输血。较低的基线血小板计数和入住重症监护病房与输血风险增加相关。COVID-19 患者的血型分布为 37%为 O 型,40%为 A 型,18%为 B 型,5%为 AB 型。非 O 型与死亡率增加无关。

结论

对 SARS-CoV-2 大流行的反应包括改变常规医院运作,使 COVID-19 患者和非 COVID-19 患者都能得到足够的治疗。尽管血型可能在 COVID-19 易感性中起作用,但它似乎与患者的死亡率无关。

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