5612535 the impact of covid19 pandemic on transfusion dependent -thalassemia management: experience of a single pediatric treatment center

Background: Health care systems have been facing COVID19 pandemic around the world for almost two years. Transfusion dependent (TDT) β-thalassemia patients represent a vulnerable group,totally dependent upon hospital-based services. Aims: Aim of the present study was to evaluate the impact of COVID19 pandemic on management of TDT patients in a single pediatric treatment center in Northern Greece. Methods: Patient records were reviewed in order to assess changes in management before and during the 24-month pandemic in Greece (03/01/2018-29/02/2020 and 03/01/2020 -28/02/2022, respectively) in terms of transfusion volume and transfusion frequency, mean value of pretransfusional hemoglobin, as well as laboratory parameters reflecting iron overload (ferritin levels, liver and heart MRI). Results: The study included 28 patients, 19 male (67.8%) and 9 female (32.2%), with an age range of 8 to 21 years. Mean number of hospital visits for transfusion was 19.97 ± 3,52/ year prior to the pandemic and 22.38 ± 4.35/year during the pandemic (p: 0.003). Average transfusion volume was 176.18ml ± 38.32/kg/year και 178.67 ± 37.64ml/kg/year, respectively (p: 0.54). With regards to hemoglobin level, mean value was 9.56 ± 0.42g/dl prior to the pandemic and 9.45 ± 0.48gr/dl during the pandemic period. As to iron overload, mean ferritin level was 1362.05 ± 517.56 ng/mL prior to the pandemic and 1021.27 ± 508.92 ng/mL during the latter time period (p:0.016). Out of 28 enrolled patients, 26 underwent heart and liver MRI before pandemic and 23 during the pandemic period. Mean LIC values were 6.84 ± 7.37 mg/gdw and 6.43 ± 6.46 mg/gdw (p: 0.97) before and during the pandemic, respectively (p:0.97). Myocardial MRI values were within normal limits both before and during the pandemic. Summary-Conclusion: Covid19 pandemic did not seem to negatively affect the primary goal of transfusion therapy (pretransfusion Hb), even if an increased number of visits was required in order to transfuse the same blood volume - due to limited availability of blood units per visit. Of interest, pandemic conditions appeared to favor patient adherence to chelation therapy. Reference 1. Jean-Mignard E et al, Transfusion Clinique et Biologique 2022; 29: 70-74