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巴西 3014 例住院 COVID-19 患者的输血情况、临床特征、合并症和结局。

Transfusion profile, clinical characteristics, comorbidities and outcomes of 3014 hospitalized patients diagnosed with COVID-19 in Brazil.

机构信息

Grupo Gestor de Serviços de Hemoterapia - Grupo GSH, Sao Paulo, Brazil.

出版信息

Vox Sang. 2021 Oct;116(9):983-989. doi: 10.1111/vox.13087. Epub 2021 Feb 26.

Abstract

BACKGROUND

The novel coronavirus disease-2019 (COVID-19) caused a sudden and unexpected increase in the number of hospital admissions and deaths worldwide. The impact of social distancing on blood stocks was significant. Data on the use of blood products by patients with COVID-19 are scarce.

MATERIAL AND METHODS

A retrospective observational study was conducted by analysing the medical records of 3014 hospitalized COVID-19 patients in 16 Brazilian hospitals. Individual data related to clinical, laboratory and transfusion characteristics and outcomes of these patients were collected. Patients characteristics association with mortality and transfusion need were tested independently by logistic regression models.

RESULTS

Patients mean age was 57·6 years. In 2298 (76·2%) patients, there was an underlying clinical comorbidity. A total of 1657 (55%) patients required admission to intensive care unit (ICU), and 943 (31%) patients required ventilatory support and orotracheal intubation (OTI). There was a total of 471 (15·6%) deaths among all patients. 325 patients (10·7%) required blood transfusion; 3187 blood products were transfused: 1364 red blood cells in 303 patients, 1092 platelet units in 78 patients, 303 fresh frozen plasma in 49 patients and 423 cryoprecipitates in 21 patients. The mortality among patients who received transfusion was substantially higher than that among the total study population.

CONCLUSION

Need for transfusion was low in COVID-19 patients, but significantly higher in patients admitted to ICU and in those who needed OTI. Knowledge of the transfusion profile of these patients allows better strategies for maintaining the blood stocks of hospitals during the pandemic.

摘要

背景

2019 年新型冠状病毒病(COVID-19)在全球范围内突然且出乎意料地导致住院人数和死亡人数增加。社交隔离对血液储备的影响是显著的。关于 COVID-19 患者使用血液制品的数据很少。

材料和方法

通过分析 16 家巴西医院的 3014 名住院 COVID-19 患者的病历,进行了一项回顾性观察性研究。收集了这些患者的临床、实验室和输血特征及结局的个体数据。通过逻辑回归模型分别测试患者特征与死亡率和输血需求的关系。

结果

患者平均年龄为 57.6 岁。在 2298 名(76.2%)患者中存在基础临床合并症。共有 1657 名(55%)患者需要入住重症监护病房(ICU),943 名(31%)患者需要呼吸机支持和经口气管插管(OTI)。所有患者的总死亡率为 471 例(15.6%)。共有 325 名患者(10.7%)需要输血;共输注 3187 个血液制品:303 名患者输注 1364 单位红细胞,78 名患者输注 1092 单位血小板,49 名患者输注 303 单位新鲜冰冻血浆,21 名患者输注 423 单位冷沉淀。接受输血的患者死亡率明显高于总研究人群。

结论

COVID-19 患者的输血需求较低,但在 ICU 患者和需要 OTI 的患者中显著更高。了解这些患者的输血情况,有助于在大流行期间更好地维持医院的血液储备。

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