Frequency and indication of blood and blood product use in general surgery practice during the pandemic period compared to the pre-pandemic period

Year 2025, Volume: 4 Issue: 3, 101 - 107, 30.09.2025

Metin Yalçın Belkıs Koçtekin

Abstract

Introductıon: This study aims to investigate whether there has been a measurable change in the use and indications of blood and blood products during the COVID-19 pandemic compared to the pre-pandemic period

Methods: A total of 1,050 patients were retrospectively analyzed, including 563 in the pre-pandemic period and 487 during the pandemic. Patients monitored for emergency benign diseases, elective benign diseases, trauma, transplantation, and malignancy were included in the study, while those with bleeding due to coagulopathy or suicide attempts were excluded. The blood products used included erythrocyte suspension, fresh frozen plasma, platelet apheresis, and pooled platelet suspension.

Results: The mean hemoglobin threshold for transfusion was significantly lower during the pandemic (7.9 ± 1.3 g/dL vs. 8.7 ± 1.8 g/dL, p < 0.001). During the pandemic, there was a statistically significant shift in blood and blood product usage patterns among surgical patients. The proportion of patients receiving one-unit erythrocyte suspension increased (22.8% vs. 12.6%, p < 0.001), while two-unit transfusions decreased. FFP use declined, it increased significantly in emergency benign diseases, colorectal/GI surgery, surgical debridement, and transplantation. Apheresis platelet transfusions increased during the pandemic (3.1% vs. 0.7%, p = 0.005), while pooled platelet use remained unchanged. Mortality was higher during the pandemic (12.5% vs. 9.4%), but the difference was not statistically significant.

Conclusion: The COVID-19 pandemic was associated with measurable shifts in blood product utilization patterns in general surgery, influenced by changes in surgical priorities and healthcare constraints.

Keywords

Blood products , Blood transfusion , Pandemic , Surgical procedures

References

• 1. Stawicki, S.P., et al., The 2019–2020 novel coronavirus (severe acute respiratory syndrome coronavirus 2) pandemic: A joint american college of academic international medicine-world academic council of emergency medicine multidisciplinary COVID-19 working group consensus paper. Journal of global infectious diseases, 2020. 12(2): p. 47-93.
• 2. Filip, R., et al., Global challenges to public health care systems during the COVID-19 pandemic: a review of pandemic measures and problems. Journal of personalized medicine, 2022. 12(8): p. 1295.
• 3. Davis, B., B.K. Bankhead-Kendall, and R.P. Dumas, A review of COVID-19’s impact on modern medical systems from a health organization management perspective. Health and technology, 2022. 12(4): p. 815-824.
• 4. Erel, Ö., et al., A sensitive indicator for the severity of COVID-19: thiol. Turkish journal of medical sciences, 2021. 51(3): p. 921-928.
• 5. Stanworth, S.J., et al., Effects of the COVID-19 pandemic on supply and use of blood for transfusion. The Lancet Haematology, 2020. 7(10): p. e756-e764.
• 6. Baron, D., et al., Patient blood management during the COVID–19 pandemic: a narrative review. Anaesthesia, 2020. 75(8): p. 1105-1113.
• 7. Chegini, A., Evaluating the importance of patient blood management during COVID-19 pandemic. Anesthesiology and Pain Medicine, 2022. 11(6): p. e112910.
• 8. Van Denakker, T.A., et al., Managing blood supplies during natural disasters, humanitarian emergencies, and pandemics: lessons learned from COVID-19. Expert review of hematology, 2023. 16(7): p. 501-514.
• 9. Alzerwi, N.A., et al. Optimizing surgical care amidst COVID-19: a scoping review of practices and policies. Healthcare, 2023. 12(1): p. 96.
• 10. Gasparovic Babic, S., A. Krsek, and L. Baticic, Voluntary blood donation in modern healthcare: Trends, challenges, and opportunities. Epidemiologia, 2024. 5(4): p. 770-784.
• 11. Singh, A.P., R. Saxena, and S. Saxena, Professional blood donors: Ethical concerns and complexities. Journal of International Research in Medical and Pharmaceutical Sciences, 2024. 19(1): p. 17-23.
• 12. Rahi, M.S., et al., Hematologic disorders associated with COVID-19: a review. Annals of hematology, 2021. 100(2): p. 309-320.
• 13. Agbuduwe, C. and S. Basu, Haematological manifestations of COVID‐19: from cytopenia to coagulopathy. European journal of haematology, 2020. 105(5): p. 540-546.
• 14. Levi, M., Pathophysiology of coagulopathy in hematological malignancies and in COVID-19. HemaSphere, 2021. 5(6): p. e571.
• 15. Mehta, A., et al., Elective surgeries during and after the COVID-19 pandemic: case burden and physician shortage concerns. Annals of Medicine and Surgery, 2022. 81: p. 104395.
• 16. Mattingly, A.S., et al., Trends in US surgical procedures and health care system response to policies curtailing elective surgical operations during the COVID-19 pandemic. JAMA Network Open, 2021. 4(12): p. e2138038-e2138038.
• 17. Coccolini, F., et al., Strategies to prevent blood loss and reduce transfusion in emergency general surgery, WSES-AAST consensus paper. World Journal of Emergency Surgery, 2024. 19(1): p. 26.
• 18. Stein, D.M., et al., National blood shortage: a call to action from the trauma community. Journal of Trauma and Acute Care Surgery, 2022. 93(3): p. e119-e122.
• 19. Lee, C., et al., Battling COVID‐19: critical care and peri‐operative healthcare resource management strategies in a tertiary academic medical centre in Singapore. Anaesthesia, 2020. 75(7): p. 861-871.
• 20. Douglas, I.S., A. Mehta, and J. Mansoori, Policy Proposals for Mitigating Intensive Care Unit Strain: Insights from the COVID-19 Pandemic. Annals of the American Thoracic Society, 2024. 21(12): p. 1633-1642.
• 21. Tyrrell, C.S., et al., Managing intensive care admissions when there are not enough beds during the COVID-19 pandemic: a systematic review. Thorax, 2021. 76(3): p. 302-312.
• 22. Pappas, H. and P. Frisch, Leveraging technology as a response to the COVID pandemic: Adapting diverse technologies, workflow, and processes to optimize integrated clinical management. 2022: CRC Press.
• 23. George, I., et al., The rapid transformation of cardiac surgery practice in the coronavirus disease 2019 (COVID-19) pandemic: insights and clinical strategies from a centre at the epicentre. European Journal of Cardio-Thoracic Surgery, 2020. 58(4): p. 667-675.
• 24. Ahn, C., et al., Global transplantation COVID report March 2020. Transplantation, 2020. 104(10): p. 1974-1983.