Clinical features and hematological findings of COVID-19 patients with blood transfusion

This paper aims to illustrate the clinical characteristics, hematological findings, and blood transfusion information of Coronavirus disease 2019 (COVID-19) patients. Twenty-three COVID-19 patients were treated and transfused with blood products in Wuhan First Hospital from February 12 to March 20, 2020. The patients were divided into a survivor group and a non-survivor group, respectively, according to whether the patient had been discharged or died. The results demonstrated at the time of initial blood transfusion, that the non-survivor group possessed a lower platelet (PLT) than that of the survivor group (P<0.001), and PLT were below the normal range in 6 (85.7%) non-survivor group and in 2 (12.5%) survivor group (P<0.01). Over half of these patients had abnormalities in fibrinogen (FIB), activated partial thromboplastin time (APTT), prothrombin time (PT), and international normalized ratio (INR), but no significant difference was found between the non-survivor group and survivor group. The non-survivor group had a dramatically higher D-Dimers and disseminated intravascular coagulation (DIC) scores than those of the survivor group (P<0.01). Six (85.7%) non-survivors but none of the survivors had a DIC score greater than 6 (P<0.001). Fifteen (93.8%) survivors and 2 (28.6%) non-survivors were transfused with RBC (P<0.01). The non-survivors (5/7) possessed a higher proportion for using AP than the survivors (2/16). The study suggests that COVID-19 patients who undergo blood transfusion usually possess coagulation dysfunction, and DIC may be closely related to deteriorating clinical outcomes.