Copyright
©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
Paradigm shift in transfusion practices during early COVID-19 pandemic: A single center retrospective study
Sumukh Arun Kumar, Sushmita Prabhu, Ankushi Sanghvi, Maya Gogtay, Mithil Gowda Suresh, Harshit Khosla, Yuvaraj Singh, Ajay Kumar Mishra, Susan George
Sumukh Arun Kumar, Sushmita Prabhu, Ankushi Sanghvi, Mithil Gowda Suresh, Susan George, Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
Maya Gogtay, Department of Hematology and Oncology, University of Nebraska Medical Center, Omaha, NE 68198, United States
Harshit Khosla, Hospice and Palliative Care, UTHSC and McGovern School of Medicine, Texas, TX 77030, United States
Yuvaraj Singh, Department of Gastroenterology and Hepatology, UMass Chan Medical School, Worcester, MA 01655, United States
Ajay Kumar Mishra, Division of Cardiology, Saint Vincent Hospital, Worcester, MA 01608, United States
Author contributions: Arun Kumar S, Prabhu S and George SV conceived the idea for the study; Arun Kumar S, Gogtay M, and Singh Y designed and undertook the literature review; Arun Kumar S, Sanghvi A, Suresh MG and Khosla H collected data; Singh Y and Mishra AK performed the statistical analysis, figures, and appendix and analyzed and interpreted the data; Arun Kumar S, Prabhu S, Sanghvi A and Gogtay M wrote the first draft of the manuscript; Arun Kumar S, Suresh MG, Khosla H, Singh Y, Mishra AK and George SV revised the subsequent drafts of the manuscript; all authors reviewed and agreed on the final draft of the manuscript.
Institutional review board statement: The study was reviewed and approved by Saint Vincent-MetroWest Medical Center Institutional Review Board (approval No. 2021-120).
Informed consent statement: The requirement of informed consent was waived by Saint Vincent- MetroWest Medical Center Institutional Review Board (approval No. 2021-120).
Conflict-of-interest statement: Our study was conducted in adherence to a well-defined protocol. The authors declare that they have no conflicts of interest regarding the publication of this manuscript.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Ajay Kumar Mishra, MD, Academic Fellow, Division of Cardiology, Saint Vincent Hospital, 123 Summer Street, Worcester, MA 01608, United States. ajaybalasore@gmail.com
Received: February 12, 2024
Revised: May 21, 2024
Accepted: June 3, 2024
Published online: June 25, 2024
Processing time: 132 Days and 13.7 Hours
BACKGROUND
The advent of coronavirus disease 2019 (COVID-19) unveiled the worst national blood crisis that the United States had witnessed in over a decade. With the pandemic influencing the different stages of the acquisition of blood products outside the hospital setting, we aimed to explore the possible barriers contributing to the shortage of blood products within the medical community.
AIM
To assess the adherence to restrictive blood transfusion practices for patients in the COVID era and pre-COVID era.
METHODS
We conducted a retrospective cross-sectional study on hospitalized patients distinguishing the pattern of blood transfusion during the COVID and pre-COVID era in a community hospital. Data was tabulated to include the number of red blood cell (RBC) transfusions and if transfusions met restrictive blood transfusion criteria as per institutional guidelines. Chi-square was applied to test the statistical association between qualitative variables. Unpaired t test and Mann Whitney U test were applied respectively to test the mean difference of quantitative variables.
RESULTS
A total of 208 patients were included in the study, of which 108 were during COVID era and 100 were during pre-COVID era. The leading reason for admission in both the COVID era and pre-COVID era transfused patients was shortness of breath (53.7% and 36% P = 0.001), followed by gastrointestinal bleeding (25.9% and 21% P = 0.001). There was a higher percentage of RBC transfusions in the intensive care unit in the COVID-era group than in the pre-COVID era group (38.9% vs 22%, P = 0.008). The restrictive transfusion criteria were met in 62% vs 79% in the COVID and pre-COVID eras, respectively (P = 0.008).
CONCLUSION
The COVID-era group received RBC transfusions with less stringent adherence to restrictive blood transfusion practices in comparison to pre-COVID era group.
Core Tip: Our study showed the percentage of liberal transfusions in a community teaching hospital almost doubled during the coronavirus disease (COVID) era compared to the pre-COVID era, shedding light on a possible change in physician mindset in adhering to restrictive transfusion guidelines during the early COVID-19 pandemic. It reiterates the importance for timely physician education on restrictive red blood cell transfusion guidelines.
