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新型冠状病毒2019感染患者的临床特征及输血指征

Clinical characteristics and indications for blood transfusion in patients with SARS-CoV-2 infection.

作者信息

Sanz Cristina, Faúndez Annabel, García Anna, Rodríguez Marta, Coromoto Jaramillo Anny, Pereira Arturo

机构信息

Blood Bank and Transfusion Service, Hospital Clínic, Barcelona, Spain.

Banc de Sang i Teixits, Barcelona, Spain.

出版信息

Med Clin (Engl Ed). 2022 Sep 9;159(5):230-233. doi: 10.1016/j.medcle.2021.07.029. Epub 2022 Sep 1.

Abstract

BACKGROUND

There are few data on the clinical characteristics of COVID-19 patients who require blood transfusion. We aimed to investigate the clinical characteristics and indication for transfusion in COVID-19 patients seen during the epidemic's first wave.

MATERIAL AND METHODS

Cross-sectional study that included all consecutive COVID-19 patients admitted to the Hospital Clínic of Barcelona, Spain, from mid-March to mid-May 2020.

RESULTS

A total of 80 patients received 354 RBC units, 116 plasma units, and 48 platelet units. Median age was 71 years (IQR: 62-76), and 59 (74%) were males. In total, 138 of the 261 transfusion episodes that involved RBCs (59%) were related to spontaneous ( = 94) or procedure-related ( = 44) bleeding. Spontaneous bleeding was more frequent in the retroperitoneal space and the gastrointestinal apparatus. Tracheostomy with endotracheal intubation, surgical interventions, and cannulation of femoral vessels were the main procedures behind non-spontaneous bleeding. Most patients (91%) were on anticoagulants, mostly intermediate- or full-dose heparin.

CONCLUSION

Anticoagulation-related bleeding was a leading cause of blood transfusion in COVID-19 patients during the epidemic's first-wave.

摘要

背景

关于需要输血的新冠病毒病(COVID-19)患者的临床特征,相关数据较少。我们旨在调查在疫情第一波期间收治的COVID-19患者的临床特征及输血指征。

材料与方法

本横断面研究纳入了2020年3月中旬至5月中旬期间连续收治于西班牙巴塞罗那临床医院的所有COVID-19患者。

结果

共有80例患者接受了354个红细胞单位、116个血浆单位和48个血小板单位的输血。中位年龄为71岁(四分位间距:62 - 76岁),59例(74%)为男性。在涉及红细胞的261次输血事件中,总计138次(59%)与自发性出血(n = 94)或与操作相关的出血(n = 44)有关。自发性出血在腹膜后间隙和胃肠道更为常见。气管切开并气管插管、外科手术干预以及股血管插管是导致非自发性出血的主要操作。大多数患者(91%)正在接受抗凝治疗,主要使用中等剂量或全剂量肝素。

结论

在疫情第一波期间,抗凝相关出血是COVID-19患者输血的主要原因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e9/9435025/ac8fe1b5cc41/gr1_lrg.jpg

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