Blood supply, transfusion demand and mortality in Italian patients hospitalised during nine months of COVID-19 pandemic

Abstract

Background - We describe blood supply and usage from March to December 2020 in two research medical hospitals in the Apulia region of Italy: Research Hospital “Casa Sollievo della Sofferenza” (Centre 1) and University Hospital of Bari (Centre 2).
Material and methods - We performed a retrospective observational study of blood component transfusions in the first eight months of the pandemic: 1^st March-31^st December 2020.
We assessed the number of hospitalised patients who were transfused, the number and type of blood components donated and the number and type of blood components transfused in different care settings.
Results - Blood donations were lower in 2020 than in 2019, with a significant reduction in red blood cells (RBC) transfused (−29% in 2020 vs 2019) and fewer transfusions in 2020 in the Internal Medicine departments (−67% and −44% in Centres 1 and 2, respectively) and Intensive Care Units (ICUs) (−53% and –54% in Centres 1 and 2, respectively). The overall number of fatalities was significantly lower in 2020 than in 2019; the proportion of fatalities in men was significantly higher in 2020 than in 2019 (53.9% and 41.5%, respectively; p=0.000). Among COVID-19 patients (n=645), 427 (66.2%) were transfused in Infectious Disease departments and the remaining in ICUs. The fatality rate was 14.3% in COVID patients transfused in Infectious Disease departments and 22.5% in those transfused in ICUs. Kaplan-Meier analysis showed
30- and 60-day mortality was significantly higher in patients transfused in 2020 compared to those transfused in 2019. Fatalities were mostly observed in COVID-19 patients.
Discussion - Present data  may be helpful in understanding the trend of collection and use of blood supplies during periods of pandemic. The implementation of a Patient Blood Management programme is essential to maintain sufficient blood supplies and to keep track of clinical outcomes that represent the most important goal of transfusion.