Active surveillance of serious adverse events following transfusion of COVID-19 convalescent plasma.
Journal
Transfusion
ISSN: 1537-2995
Titre abrégé: Transfusion
Pays: United States
ID NLM: 0417360
Informations de publication
Date de publication:
01 2022
01 2022
Historique:
revised:
07
10
2021
received:
30
04
2021
accepted:
07
10
2021
pubmed:
23
10
2021
medline:
28
1
2022
entrez:
22
10
2021
Statut:
ppublish
Résumé
The reported incidence of adverse reactions following Coronavirus disease 2019 (COVID-19) convalescent plasma (CCP) transfusion has generally been lower than expected based on the incidence of transfusion reactions that have been observed in studies of conventional plasma transfusion. This raises the concern for under-reporting of adverse events in studies of CCP that rely on passive surveillance strategies. Our institution implemented a protocol to actively identify possible adverse reactions to CCP transfusion. In addition, we retrospectively reviewed the charts of inpatients who received CCP at Stanford Hospital between May 13, 2020 and January 31, 2021. We determined the incidence of adverse events following CCP transfusion. A total of 49 patients received CCP. Seven patients (14%) had an increased supplemental oxygen requirement within 4 h of transfusion completion, including one patient who was intubated during the transfusion. An additional 11 patients (total of 18, 37%) had increased oxygen requirements within 24 h of transfusion, including 3 patients who were intubated. Six patients (12%) fulfilled criteria for transfusion-associated circulatory overload (TACO). Using an active surveillance strategy, we commonly observed adverse events following the transfusion of CCP to hospitalized patients. It was not possible to definitively determine whether or not these adverse events are related to CCP transfusion. TACO was likely over-diagnosed given overlap with the manifestations of COVID-19. Nevertheless, these results suggest that the potential adverse effects of CCP transfusion may be underestimated by reports from passive surveillance studies.
Sections du résumé
BACKGROUND
The reported incidence of adverse reactions following Coronavirus disease 2019 (COVID-19) convalescent plasma (CCP) transfusion has generally been lower than expected based on the incidence of transfusion reactions that have been observed in studies of conventional plasma transfusion. This raises the concern for under-reporting of adverse events in studies of CCP that rely on passive surveillance strategies.
MATERIALS AND METHODS
Our institution implemented a protocol to actively identify possible adverse reactions to CCP transfusion. In addition, we retrospectively reviewed the charts of inpatients who received CCP at Stanford Hospital between May 13, 2020 and January 31, 2021. We determined the incidence of adverse events following CCP transfusion.
RESULTS
A total of 49 patients received CCP. Seven patients (14%) had an increased supplemental oxygen requirement within 4 h of transfusion completion, including one patient who was intubated during the transfusion. An additional 11 patients (total of 18, 37%) had increased oxygen requirements within 24 h of transfusion, including 3 patients who were intubated. Six patients (12%) fulfilled criteria for transfusion-associated circulatory overload (TACO).
CONCLUSION
Using an active surveillance strategy, we commonly observed adverse events following the transfusion of CCP to hospitalized patients. It was not possible to definitively determine whether or not these adverse events are related to CCP transfusion. TACO was likely over-diagnosed given overlap with the manifestations of COVID-19. Nevertheless, these results suggest that the potential adverse effects of CCP transfusion may be underestimated by reports from passive surveillance studies.
Identifiants
pubmed: 34677830
doi: 10.1111/trf.16711
pmc: PMC8661846
doi:
Substances chimiques
Oxygen
S88TT14065
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
28-36Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR003142
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1TR003142
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1TR003142
Pays : United States
Informations de copyright
© 2021 AABB.
Références
Mayo Clin Proc. 2020 Sep;95(9):1888-1897
pubmed: 32861333
N Engl J Med. 2021 Nov 18;385(21):1951-1960
pubmed: 34407339
J Clin Invest. 2020 Sep 1;130(9):4791-4797
pubmed: 32525844
Vox Sang. 2021 Apr;116(4):434-439
pubmed: 33103789
Lancet Oncol. 2016 May;17(5):e209-19
pubmed: 27301048
N Engl J Med. 2021 Mar 18;384(11):1015-1027
pubmed: 33523609
Vox Sang. 2015 May;108(4):387-92
pubmed: 25753261
Transfusion. 2012 May;52 Suppl 1:65S-79S
pubmed: 22578374
J Am Coll Cardiol. 2020 Feb 18;75(6):620-628
pubmed: 32057377
N Engl J Med. 2021 Feb 18;384(7):610-618
pubmed: 33406353
Transfusion. 2012 Jan;52(1):160-5
pubmed: 21762464
Transfus Med Rev. 2020 Jul;34(3):151-157
pubmed: 32703664
Transfusion. 2021 Jan;61(1):78-93
pubmed: 33125158
BMJ. 2020 Oct 22;371:m3939
pubmed: 33093056
JAMA. 2020 Aug 4;324(5):460-470
pubmed: 32492084
J Thromb Haemost. 2016 Feb;14(2):324-30
pubmed: 26644327
Transfusion. 2017 Sep;57(9):2104-2114
pubmed: 28766723
N Engl J Med. 2021 Feb 18;384(7):619-629
pubmed: 33232588
Transfus Med Rev. 2020 Jul;34(3):141-144
pubmed: 32359789
Transfusion. 2022 Jan;62(1):28-36
pubmed: 34677830