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      Impact of COVID‐19 and lockdown regarding blood transfusion

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          Abstract

          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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          Most cited references42

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          Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

          Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p<0·0001), and d-dimer greater than 1 μg/mL (18·42, 2·64–128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0–24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days. Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.
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            A Novel Coronavirus from Patients with Pneumonia in China, 2019

            Summary In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.)
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              Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China

              In December 2019, novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited.
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                Author and article information

                Contributors
                paulmichel.mertes@chru-strasbourg.fr
                Journal
                Transfusion
                Transfusion
                10.1111/(ISSN)1537-2995
                TRF
                Transfusion
                John Wiley & Sons, Inc. (Hoboken, USA )
                0041-1132
                1537-2995
                13 July 2021
                August 2021
                13 July 2021
                : 61
                : 8 ( doiID: 10.1111/trf.v61.8 )
                : 2327-2335
                Affiliations
                [ 1 ] Anaesthesia, Intensive Care and Perioperative Medicine, Nouvel Hôpital Civil Strasbourg University Hospital Strasbourg France
                [ 2 ] Établissement Français du Sang Grand‐Est, site de Strasbourg Strasbourg France
                [ 3 ] Transfusion Medicine Strasbourg University Hospital Strasbourg France
                [ 4 ] Department for Medical Information Strasbourg University Hospital Strasbourg France
                [ 5 ] ICANS Strasbourg France
                Author notes
                [*] [* ] Correspondence

                Paul‐Michel Mertes, Anaesthesia, Intensive Care and Perioperative Medicine, Nouvel Hôpital Civil, 1, Place de l'Hôpital, F‐67000 Strasbourg, France.

                Email: paulmichel.mertes@ 123456chru-strasbourg.fr

                Author information
                https://orcid.org/0000-0002-5585-6792
                Article
                TRF16422
                10.1111/trf.16422
                8447413
                34255374
                00715dad-1e77-4256-bf3c-c5f3ea088991
                © 2021 AABB

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                History
                : 10 March 2021
                : 11 January 2021
                : 10 March 2021
                Page count
                Figures: 5, Tables: 2, Pages: 9, Words: 5450
                Categories
                Transfusion Practice
                Transfusion Practice
                Custom metadata
                2.0
                August 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.7 mode:remove_FC converted:17.09.2021

                Hematology
                blood donation,covid‐19,lockdown,transfusion
                Hematology
                blood donation, covid‐19, lockdown, transfusion

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