Predictors of Red Blood Cell Transfusion in Elderly COVID-19 Patients in Korea
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: Patients who experience clinical deterioration from coronavirus disease (COVID-19) require blood transfusion support. We analyzed blood component usage in COVID-19 patients and identified the predictors of red blood cell (RBC) transfusion in elderly (≥65 years) patients. Methods: Blood component usage in 882 COVID-19 patients hospitalized between January 24, 2020 and April 30, 2021 was analyzed. Elderly patients were categorized into transfused and non-transfused groups according to their RBC transfusion history; their demographic and clinical characteristics, disease severity, and outcomes were compared. Associations were determined using multiple logistic regression. Results: The overall transfusion rate was 8.3% (73/882), and the transfusion rate was 2.7% (14/524) in patients aged <65 years and 16.5% (59/358) in those aged ≥65 years. Among the 358 elderly patients, 344 patients, including 50 who received transfusion and 294 who did not, were enrolled for the analysis. The prevalence of diabetes mellitus (DM), white blood cell count, absolute neutrophil count, and neutrophil-to-lymphocyte ratio (NLR) on admission were significantly higher in the transfused group, whereas Hb and platelet counts were significantly lower. Disease severity in the transfused group was relatively high on admission and increased thereafter. DM, intensive care unit entrance on admission, Hb, platelet count, and NLR on admission were independently associated with RBC transfusion. Conclusions: This study presents transfusion rates in COVID-19 patients according to age groups and predictors of RBC transfusion in elderly patients. The results provide a basis for developing a strategy for the medical treatment of infectious diseases emerging during pandemics.
Abstract
Background: Patients who experience clinical deterioration from coronavirus disease (COVID-19) require blood transfusion support. We analyzed blood component usage in COVID-19 patients and identified the predictors of red blood cell (RBC) transfusion in elderly (≥65 years) patients. Methods: Blood component usage in 882 COVID-19 patients hospitalized between January 24, 2020 and April 30, 2021 was analyzed. Elderly patients were categorized into transfused and non-transfused groups according to their RBC transfusion history; their demographic and clinical characteristics, disease severity, and outcomes were compared. Associations were determined using multiple logistic regression. Results: The overall transfusion rate was 8.3% (73/882), and the transfusion rate was 2.7% (14/524) in patients aged <65 years and 16.5% (59/358) in those aged ≥65 years. Among the 358 elderly patients, 344 patients, including 50 who received transfusion and 294 who did not, were enrolled for the analysis. The prevalence of diabetes mellitus (DM), white blood cell count, absolute neutrophil count, and neutrophil-to-lymphocyte ratio (NLR) on admission were significantly higher in the transfused group, whereas Hb and platelet counts were significantly lower. Disease severity in the transfused group was relatively high on admission and increased thereafter. DM, intensive care unit entrance on admission, Hb, platelet count, and NLR on admission were independently associated with RBC transfusion. Conclusions: This study presents transfusion rates in COVID-19 patients according to age groups and predictors of RBC transfusion in elderly patients. The results provide a basis for developing a strategy for the medical treatment of infectious diseases emerging during pandemics.
참고문헌 (31)
- Gehrie E, "Transfusion service response to the COVID-19 pandemic", Am J Clin Pathol, 154, pp.280~285 (2020)
- Gehrie EA, "Balancing supply and demand for blood during the COVID-19 pandemic", Anesthesiology, 133, pp.16~18 (2020)
- Pagano MB, "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, 60, pp.908~911 (2020)
- Cai X, "Blood transfusion during the COVID-19 outbreak", Blood Transfus, 18, pp.79~82 (2020)
- Flegel WA, "CoVID-19 insights from transfusion medicine", Br J Haematol, 190, pp.715~717 (2020)
- Thachil J, "ISTH interim guidance on recognition and management of coagulopathy in COVID-19", J Thromb Haemost, 18, pp.1023~1026 (2020)
- Barriteau CM, "Blood transfusion utilization in hospitalized COVID-19 patients", Transfusion, 60, pp.1919~1923 (2020)
- DeSimone RA, "Blood component utilization in COVID-19 patients in New York City : transfusions do not follow the curve", Transfusion, 61, pp.692~698 (2021)
- Doyle AJ, "Blood component use in critical care in patients with COVID-19 infection : a single-centre experience", Br J Haematol, 191, pp.382~385 (2020)
- Fan BE, "Blood and blood product use during COVID-19 infection", Am J Hematol, 95, pp.E158~E160 (2020)
- Pagano MB, "Blood use and transfusion needs at a large health care system in Washington state during the SARS-CoV-2 pandemic", Transfusion, 60, pp.2859~2866 (2020)
- Rim JH, "Transfusion demand in COVID-19 patients from the Korean population : a nationwide study in South Korea", Br J Haematol, 190, pp.e323~e326 (2020)
- Velázquez-Kennedy K, "Transfusion support in COVID-19 patients : impact on hospital blood component supply during the outbreak", Transfusion, 61, pp.361~367 (2021)
- Hernández-Maraver D, "Transfusion medicine during COVID-19 outbreak in the hotspot of Spain", Transfusion, 60, pp.2762~2764 (2020)
- Fagard K, "Risk factors for severe COVID-19 disease and death in patients aged 70 and over : a retrospective observational cohort study", Acta Clin Belg, 21, pp.1~8 (2021)
- Gao YD, "Risk factors for severe and critically ill COVID-19 patients : a review", Allergy, 76, pp.428~455 (2021)
- Sung Ho Kyung, "Clinical Course and Outcomes of 3,060 Patients with Coronavirus Disease 2019 in Korea, January–May 2020", Journal of Korean Medical Science, 35(30), pp.1~11 (2020), 대한의학회[DOI]
- Sanyaolu A, "Comorbidity and its impact on patients with COVID-19", SN Compr Clin Med, 2, pp.1069~1076 (2020)
- WHO Working Group on the Clinical Characterisation and Management of COVID-19 infection, "A minimal common outcome measure set for COVID-19 clinical research", Lancet Infect Dis, 20, pp.e192~7 (2020)
- Kim Y, "Letter to Editor : Strategy for hospitalization and discharge of COVID-19 patients : based on the nationwide clinical course analysis", J Korean Med Sci, 35, pp.e353~ (2020)
- Terpos E, "Hematological findings and complications of COVID-19", Am J Hematol, 95, pp.834~847 (2020)
- Sanz C, "Hemorrhage is a major cause of blood transfusion in COVID-19 patients", Blood, 136, pp.21~22 (2020)
- Koeckerling D, "Blood transfusion strategies and ECMO during the COVID-19 pandemic", Lancet Respir Med, 8, pp.e40~ (2020)
- "Coronavirus Disease-19, Republic of Korea" (2022)[URL]
- Petrilli CM, "Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City : prospective cohort study", BMJ, 369, pp.m1966~ (2020)
- Guo L, "Comorbid diabetes and the risk of disease severity or death among 8807 COVID-19 patients in China : a meta-analysis", Diabetes Res Clin Pract, 166, pp.108346~ (2020)
- Dalmazzo LFF, "Transfusion profile, clinical characteristics, comorbidities and outcomes of 3014 hospitalized patients diagnosed with COVID‐19 in Brazil", Vox Sang, 116, pp.983~989 (2021)
- Li X, "Predictive values of neutrophil-to-lymphocyte ratio on disease severity and mortality in COVID-19 patients : a systematic review and meta-analysis", Crit Care, 24, pp.647~ (2020)
- Simadibrata DM, "Neutrophil-to-lymphocyte ratio on admission to predict the severity and mortality of COVID-19 patients : a meta-analysis", Am J Emerg Med, 42, pp.60~69 (2021)
- Salehi S, "Coronavirus disease 2019(COVID-19) : a systematic review of imaging findings in 919 patients", AJR Am J Roentgenol, 215, pp.87~93 (2020)
- Huang C, "Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China", Lancet, 395, pp.497~506 (2020)