Drop for drop: A descriptive analysis of blood product usage in a South African tertiary care setting during the Covid-19 pandemic

Abstract

Background: The Covid-19 pandemic has had a drastic effect on the global community. Blood products are precious resources especially in the African context and this has been especially compounded during the Covid-19 pandemic. Concurrent to this during the Covid-19 level 5 lockdown in South Africa from 26 March – 30 April 2020, a decrease in trauma admissions to state hospitals was noted. The aim of this data collection was to assess whether lowered blood product issuance was seen during the Covid-19 pandemic lockdown. Method: Areas at Tygerberg Hospital with trauma patients were identified, namely: the A1W intensive care unit (Surgical ICU), Trauma Front Room (Trauma Admissions), Trauma Resuscitation unit (Trauma Resus Area) and J7(Trauma Ward). Data of blood product issuance (red blood cells and fresh frozen plasma) for these 4 areas was provided by the Western Cape Blood Service for the period 26 March-30 April 2018, 2019 and 2020. This included the stage 5 Covid-19 South African lockdown, as well as Easter for all three years which is traditionally associated with raised trauma admissions. This data was quantitative. Results: 201 products were issued in 2018 versus 103 for the same period in 2020 for the 4 trauma areas in Tygerberg Hospital. The surgical ICU received the most products over 3 years with 183 of the product issuances. Discussion: As expected there was a significant decrease in blood product (red blood cell and fresh frozen plasma) issuance during the 2020 period which paralleled the lowered trauma numbers. This represented a significant cost saving of over R150 000 despite increased yearly costs for blood products over the same period. This data collection did not consider the reasoning for these blood transfusions or the clinical appropriateness thereof. The author acknowledges the wide variability of transfusion thresholds and protocols within various centres around the world, including Tygerberg and was not seeking to prove commentary on the appropriateness thereof in this research.