Hospital red blood cell and platelet supply and utilization from March to December of the first year of the COVID-19 pandemic: The BEST collaborative study
Corresponding Author
Wen Lu
Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA
Correspondence
Wen Lu, Brigham and Women's Hospital, Blood Bank, Cotran 260, 75 Francis Street, Boston, MA 02115, USA.
Email: [email protected]
Search for more papers by this authorMark Yazer
Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Search for more papers by this authorNa Li
Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
Search for more papers by this authorAlyssa Ziman
Wing-Kwai and Alice Lee-Tsing Chung Transfusion Service, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
Search for more papers by this authorSilvano Wendel
Hospital Sírio-Libanês Blood Bank, São Paulo, Brazil
Search for more papers by this authorHongying Tang
Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA
Search for more papers by this authorHamilton Tsang
Department of Laboratory Medicine and Pathology, Transfusion Medicine Division, University of Washington, Seattle, Washington, USA
Search for more papers by this authorKjell Titlestad
Department of Clinical Immunology, Odense University, South Danish Transfusion Services, Odense, Denmark
Search for more papers by this authorSuzanne R. Thibodeaux
Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
Search for more papers by this authorAndrew W. Shih
Department of Pathology and Laboratory Medicine, Vancouver General Hospital, Vancouver, British Columbia, Canada
Search for more papers by this authorJessica L. Poisson
Department of Pathology, Duke University Hospital, Durham, North Carolina, USA
Search for more papers by this authorMonica B. Pagano
Department of Laboratory Medicine and Pathology, Transfusion Medicine Division, University of Washington, Seattle, Washington, USA
Search for more papers by this authorHua Shan
Transfusion Medicine Service, Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
Search for more papers by this authorMike Murphy
Radcliffe Department of Medicine, University of Oxford, Oxford, UK
Search for more papers by this authorColin Murphy
Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA
Search for more papers by this authorMariana Lorenzi Savioli
Hemotherapy and Cell Therapy Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
Search for more papers by this authorJosé Mauro Kutner
Hemotherapy and Cell Therapy Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
Search for more papers by this authorAaron S. Hess
Department of Anesthesiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
Search for more papers by this authorMagali J. Fontaine
Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA
Search for more papers by this authorRoberta Fachini
Hospital Sírio-Libanês Blood Bank, São Paulo, Brazil
Search for more papers by this authorNancy M. Dunbar
Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
Search for more papers by this authorRichard M. Kaufman
Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA
Search for more papers by this authorBiomedical Excellence for Safer Transfusions Collaborative
Search for more papers by this authorCorresponding Author
Wen Lu
Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA
Correspondence
Wen Lu, Brigham and Women's Hospital, Blood Bank, Cotran 260, 75 Francis Street, Boston, MA 02115, USA.
Email: [email protected]
Search for more papers by this authorMark Yazer
Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Search for more papers by this authorNa Li
Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
Search for more papers by this authorAlyssa Ziman
Wing-Kwai and Alice Lee-Tsing Chung Transfusion Service, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
Search for more papers by this authorSilvano Wendel
Hospital Sírio-Libanês Blood Bank, São Paulo, Brazil
Search for more papers by this authorHongying Tang
Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA
Search for more papers by this authorHamilton Tsang
Department of Laboratory Medicine and Pathology, Transfusion Medicine Division, University of Washington, Seattle, Washington, USA
Search for more papers by this authorKjell Titlestad
Department of Clinical Immunology, Odense University, South Danish Transfusion Services, Odense, Denmark
Search for more papers by this authorSuzanne R. Thibodeaux
Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
Search for more papers by this authorAndrew W. Shih
Department of Pathology and Laboratory Medicine, Vancouver General Hospital, Vancouver, British Columbia, Canada
Search for more papers by this authorJessica L. Poisson
Department of Pathology, Duke University Hospital, Durham, North Carolina, USA
Search for more papers by this authorMonica B. Pagano
Department of Laboratory Medicine and Pathology, Transfusion Medicine Division, University of Washington, Seattle, Washington, USA
Search for more papers by this authorHua Shan
Transfusion Medicine Service, Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
Search for more papers by this authorMike Murphy
Radcliffe Department of Medicine, University of Oxford, Oxford, UK
Search for more papers by this authorColin Murphy
Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA
Search for more papers by this authorMariana Lorenzi Savioli
Hemotherapy and Cell Therapy Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
Search for more papers by this authorJosé Mauro Kutner
Hemotherapy and Cell Therapy Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
Search for more papers by this authorAaron S. Hess
Department of Anesthesiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
Search for more papers by this authorMagali J. Fontaine
Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA
Search for more papers by this authorRoberta Fachini
Hospital Sírio-Libanês Blood Bank, São Paulo, Brazil
Search for more papers by this authorNancy M. Dunbar
Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
Search for more papers by this authorRichard M. Kaufman
Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA
Search for more papers by this authorBiomedical Excellence for Safer Transfusions Collaborative
Search for more papers by this authorAbstract
Background
At the start of the coronavirus disease 2019 (COVID-19) pandemic, widespread blood shortages were anticipated. We sought to determine how hospital blood supply and blood utilization were affected by the first wave of COVID-19.
Study Design and Methods
Weekly red blood cell (RBC) and platelet (PLT) inventory, transfusion, and outdate data were collected from 13 institutions in the United States, Brazil, Canada, and Denmark from March 1st to December 31st of 2020 and 2019. Data from the sites were aligned based on each site's local first peak of COVID-19 cases, and data from 2020 (pandemic year) were compared with data from the corresponding period in 2019 (pre-pandemic baseline).
Results
RBC inventories were 3% lower in 2020 than in 2019 (680 vs. 704, p < .001) and 5% fewer RBCs were transfused per week compared to 2019 (477 vs. 501, p < .001). However, during the first COVID-19 peak, RBC and PLT inventories were higher than normal, as reflected by deviation from par, days on hand, and percent outdated. At this time, 16% fewer inpatient beds were occupied, and 43% fewer surgeries were performed compared to 2019 (p < .001). In contrast to 2019 when there was no correlation, there was, in 2020, significant negative correlations between RBC and PLT days on hand and both percentage occupancy of inpatient beds and percentage of surgeries performed.
Conclusion
During the COVID-19 pandemic in 2020, RBC and PLT inventories remained adequate. During the first wave of cases, significant decreases in patient care activities were associated with excess RBC and PLT supplies and increased product outdating.
CONFLICT OF INTEREST
The authors have disclosed no conflicts of interest.
Supporting Information
| Filename | Description |
|---|---|
| trf17023-sup-0001-supinfo.docxWord 2007 document , 22 KB | Supplemental Table 1. Blood supply, utilization, and patient care activity: 2019 (baseline) vs. 2020 (COVID) with baseline adjustment. Supplemental Table 2. Blood supply, utilization, and patient care activity: post-first peak baseline vs. post-first peak period. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
REFERENCES
- 1 WHO. WHO Director-General's opening remarks at the media briefing on COVID-19. 2020. Available from: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020. Accessed 30 Aug 2021.
- 2 WHO. World Health Organization: Interim guidance on maintaining a safe and adequate blood supply during the pan- demic outbreak of coronavirus disease (COVID-19). 2020. Available from: https://www.who.int/publications/i/item/WHO-2019-nCoV-BloodSupply-2021-1. Accessed 30 Aug 2021.
- 3Pagano MB, Hess JR, Tsang HC, Staley E, Gernsheimer T, Sen N, et al. Prepare to adapt: blood supply and transfusion support during the first 2 weeks of the 2019 novel coronavirus (COVID-19) pandemic affecting Washington state. Transfusion. 2020; 60: 908–11.
- 4Gehrie EA, Tormey CA, Sanford KW. Transfusion service response to the COVID-19 pandemic. Am J Clin Pathol. 2020; 154: 280–5.
- 5Gehrie EA, Frank SM, Goobie SM. Balancing supply and demand for blood during the COVID-19 pandemic. Anesthesiology. 2020; 133: 16–8.
- 6Stanworth Simon J, New Helen V, Apelseth Torunn O, Brunskill S, Cardigan R, Doree C, et al. Effects of the COVID-19 pandemic on supply and use of blood for transfusion. Lancet Haematol. 2020; 7: e756–64.
- 7Yahia AIO. Management of blood supply and demand during the COVID-19 pandemic in King Abdullah Hospital, Bisha, Saudi Arabia. Transfus Apher Sci. 2020; 59:102836.
- 8Maghsudlu M, Eshghi P, Amini Kafi-Abad S, Sedaghat A, Ranjbaran H, Mohammadi S, et al. Blood supply sufficiency and safety management in Iran during the COVID-19 outbreak. Vox Sang. 2021; 116(2): 175–80. https://doi.org/10.1111/vox.13012
- 9Tan PP, Chang CT, Noor CM. Blood supply management during the Covid-19 pandemic: experience in a tertiary referral hospital in Malaysia. Transfus Apher Sci. 2021; 60(1):102982. https://doi.org/10.1016/j.transci.2020.102982
- 10Yongjun W, Wenjuan H, Lingling P, Wang C, Liu Y, Hu W, et al. Impact of COVID-19 on blood centres in Zhejiang province China. Vox Sang. 2020; 115: 502–6.
- 11Loua A, Kasilo OMJ, Nikiema JB, Sougou AS, Kniazkov S, Annan EA. Impact of the COVID-19 pandemic on blood supply and demand in the WHO African region. Vox Sang. 2021; 116(7): 774–84. https://doi.org/10.1111/vox.13071
- 12Grandone E, Mastroianno M, Caroli A, Ostuni A. Blood supply and transfusion support in southern Italy: findings during the first four weeks of the SARS-CoV-2 pandemic. Blood Transfus. 2020; 18(3): 230–2. https://doi.org/10.2450/2020.0107-20
- 13McGinnis E, Guo RJ, Marcon KM, Berry B, Coupland R, Meneghetti V, et al. Adaptations of transfusion systems to the COVID-19 pandemic in British Columbia, Canada: early experiences of a large tertiary care center and survey of provincial activities. Transfusion. 2021; 61(4): 1102–11. https://doi.org/10.1111/trf.16265
- 14Prokopchuk-Gauk O, Petraszko T, Nahirniak S, Doncaster C, Levy I. Blood shortages planning in Canada: the National Emergency Blood Management Committee experience during the first 6 months of the COVID-19 pandemic. Transfusion. 2021; 61(11): 3258–66. https://doi.org/10.1111/trf.16661
- 15 American Red Cross. American Red Cross email communication: March 19, 2020 from Pampee P. Young, M.D., Ph.D., Chief Medical Officer, American Red Cross.
- 16Pagano MB, Cataife G, Fertrin KY, Gernsheimer T, Hess JR, Staley E, et al. Blood utilization and transfusion needs during the first 6 weeks of the COVID pandemic in Washington state. Transfusion. 2020; 60: 2859–66. https://doi.org/10.1111/trf.16051
- 17 ACS. COVID-19: executive orders by state on dental, medical, and surgical procedures. Available from: https://www.facs.org/covid-19/legislative-regulatory/executive-orders. Accessed 22 June 2021.
- 18DeSimone RA, Costa VA, Kane K, Sepulveda JL, Ellsworth GB, Gulick RM, et al. Blood component utilization in COVID-19 patients in New York City: transfusions do not follow the curve. Transfusion. 2021; 61(3): 692–8. https://doi.org/10.1111/trf.16202
- 19Barriteau CM, Bochey P, Lindholm PF, Hartman K, Sumugod R, Ramsey G. Blood transfusion utilization in hospitalized COVID-19 patients. Transfusion. 2020; 60: 1919–23. https://doi.org/10.1111/trf.15947
- 20Cai X, Ren M, Chen F, Li L, Lei H, Wang X. Blood transfusion during the COVID-19 outbreak. Blood Transfus. 2020; 18(79–82): 10.
- 21Al-Riyami AZ, Abdella YE, Badawi MA, Panchatcharam SM, Ghaleb Y, Maghsudlu M, et al. The impact of COVID-19 pandemic on blood supplies and transfusion services in Eastern Mediterranean Region. Transfus Clin Biol. 2021; 28(1): 16–24. https://doi.org/10.1016/j.tracli.2020.11.002
- 22 National Blood Authority. Managing blood and blood product inventory - tip 3: set appropriate inventory levels. Available from: https://www.blood.gov.au/inv-mgt-guideline-tip-3-set-appropriate-levels. Accessed 29 Sept 2021.
- 23 R Core Team. R: a language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2020 Available from: https://www.R-project.org/
- 24Stephenson J. Canceled blood drives, social distancing cause Nationwide blood shortages. JAMA Health Forum. 2020; 1(3):e200380 Available from: https://jamanetwork.com/journals/jama-health-forum/fullarticle/2764021. Accessed 20 Jan 2022
10.1001/jamahealthforum.2020.0380 Google Scholar
- 25Rajbhandary S, Shmookler A, Cohn CS, Nunes E, Karafin MS, Stubbs J, et al. Hospital transfusion service operations during the SARS-CoV-2 pandemic: lessons learned from the AABB hospital survey in preparation for the next infectious disease outbreak. Transfusion. 2021; 61(11): 3129–38. https://doi.org/10.1111/trf.16643
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