Effects of the COVID-19 pandemic on supply and use of blood for transfusion

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Summary

The COVID-19 pandemic has major implications for blood transfusion. There are uncertain patterns of demand, and transfusion institutions need to plan for reductions in donations and loss of crucial staff because of sickness and public health restrictions. We systematically searched for relevant studies addressing the transfusion chain—from donor, through collection and processing, to patients—to provide a synthesis of the published literature and guidance during times of potential or actual shortage. A reduction in donor numbers has largely been matched by reductions in demand for transfusion. Contingency planning includes prioritisation policies for patients in the event of predicted shortage. A range of strategies maintain ongoing equitable access to blood for transfusion during the pandemic, in addition to providing new therapies such as convalescent plasma. Sharing experience and developing expert consensus on the basis of evolving publications will help transfusion services and hospitals in countries at different stages in the pandemic.

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Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

Chaolin Huang, Yeming Wang, Xingwang Li … (2020)

Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.

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Clinical Characteristics of Coronavirus Disease 2019 in China

Wei-jie Guan, Zheng-yi Ni, Yu Hu … (2020)

Abstract Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. Methods We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Results The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. Conclusions During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.)

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Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area

Safiya Richardson, Jamie Hirsch, Mangala Narasimhan … (2020)

There is limited information describing the presenting characteristics and outcomes of US patients requiring hospitalization for coronavirus disease 2019 (COVID-19).

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Author and article information

Contributors

Simon J Stanworth

Journal

Journal ID (nlm-ta): Lancet Haematol

Journal ID (iso-abbrev): Lancet Haematol

Title: The Lancet. Haematology

Publisher: Elsevier Ltd.

ISSN (Electronic): 2352-3026

Publication date PMC-release: 3 July 2020

Publication date (Electronic): 3 July 2020

Affiliations

[a ]Transfusion Medicine, NHS Blood and Transplant, Oxford, UK

[b ]Systematic Review Initiative, NHS Blood and Transplant, Oxford, UK

[c ]Department of Haematology, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK

[d ]Radcliffe Department of Medicine and NIHR Oxford Biomedical Research Centre—Haematology Theme, University of Oxford, Oxford, UK

[e ]NHS Blood and Transplant, London, UK

[f ]Department of Haematology, Imperial College London, London, UK

[g ]Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway

[h ]Norwegian Armed Forces Medical Services, Oslo, Norway

[i ]NHS Blood and Transplant, Cambridge, UK

[j ]Department of Haematology, University of Cambridge, Cambridge, UK

[k ]Medical Affairs and Innovation, Héma-Québec, Québec, QC, Canada

[l ]Medical Affairs and Innovation, Canadian Blood Services, Ottawa, ON, Canada

[m ]NHS Blood and Transplant, Bristol, UK

[n ]Department of Transfusion Medicine and Hematology, IRCCS Ca ‘Granda Hospital Maggiore Policlinico Foundation, Milan, Italy

[o ]Department of Medicine, Division of Haematology, Mount Sinai Hospital, ON, Canada

[p ]Department of Medicine, and Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada

[q ]University Health Network, Department of Medicine, Division of Medical Oncology and Haematology, Toronto, ON, Canada

[r ]Department of Transfusion Medicine, Sanquin Blood Supply Foundation, Amsterdam, Netherlands

[s ]Department of Haematology, Erasmus Medical Center, Rotterdam, Netherlands

[t ]Manchester University NHS Foundation Trust, Manchester, UK

Author notes

[* ]Correspondence to: Prof Simon J Stanworth, Transfusion Medicine, NHS Blood and Transplant, John Radcliffe Hospital, Oxford OX3 9BQ, UK simon.stanworth@ 123456nhsbt.nhs.uk

Article

Publisher ID: S2352-3026(20)30186-1

DOI: 10.1016/S2352-3026(20)30186-1

PMC ID: 7333996

PubMed ID: 32628911

SO-VID: 8218f63c-3296-4f5d-a7f6-3ea26705e9fb

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Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

Effects of the COVID-19 pandemic on supply and use of blood for transfusion

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Novel Coronavirus Disease COVID-19

Most cited references 104

Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

Clinical Characteristics of Coronavirus Disease 2019 in China

Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area

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