Abstract Number: PB0205
Meeting: ISTH 2021 Congress
Background: The high incidence of thrombotic events in patients with COVID-19 affects healthcare worldwide and results in an increased workload in haemostasis laboratories. Especially D-dimer, haemostatic parameters and anti-Xa tests are expected to be analysed more frequently. However, the impact of this increase in assay requests on the quality of performance in haemostasis laboratories remains unclear.
Aims: To evaluate the impact of the COVID-19 pandemic on the quality performance and management of haemostasis laboratories.
Methods: The impact on the quality of performance was studied using external quality assessment (EQA) data from 2019 and 2020 derived from ECAT surveys. A questionnaire was sent to Dutch haemostasis laboratories to identify challenges and management strategies during the COVID-19 pandemic with focus on D-dimer, anti-Xa, factor VIII and fibrinogen. Furthermore, the number of assays performed in 2019 and 2020 was collected from four Dutch hospitals, located in regions with different disease incidence.
Results: No differences in response rate nor the quality of the measurements were observed between the EQA surveys in 2019 and 2020 (Table 1). Fifty-five percent of the laboratories observed a more than 25% increase in test requests for anti-Xa and D-dimer assays in 2020 compared to 2019. Twenty-seven percent also experienced this increase in requested fibrinogen assays. Additionally, 84% of the respondents indicated to experience increased work pressure and increased absenteeism in 71% of the participating laboratories was observed. Evaluation of the number of assays performed over the year showed extreme peaks in anti-Xa assays (144 – 772%) in all four hospitals and D-dimer assays (368%, 670%) in the two hospitals that are located in areas with high disease incidence.
|Mean ± SD||Mean ± SD||p value|
|Fibrinogen (g/L)||6.8 ± 1.3||8.1 ± 1.4||n.s.|
|D-dimer (mg/L)||10.0 ± 3.0||9.4 ± 2.3||n.s.|
|Factor VIII (%)||8.1 ± 1.4||10.5 ± 4.3||n.s.|
|Anti-Xa (UFH) (IU/mL)||6.5 ± 1.5||7.3 ± 3.9||n.s.|
|Anti-Xa (LMWH) (IU/mL)||10.2 ± 4.2||10.0 ± 3.9||n.s.|
CV, between participants coefficient of variation of two similar samples derived from two different surveys
n.s., not significant difference between pre-COVID19 and COVID19
Conclusions: The enormous increase in work pressure and test requests, especially for D-dimer assays and anti-Xa activity, did not affect the quality of performance within haemostatic laboratories during the COVID-19 pandemic.
To cite this abstract in AMA style:Arisz RA, Meijer P, CV Péquériaux N, J van de Leur S, V Lukens M, PM de Maat M, J Hollestelle M. Impact of COVID-19 Pandemic on the Quality and Performance of Haemostasis Laboratories [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 1). https://abstracts.isth.org/abstract/impact-of-covid-19-pandemic-on-the-quality-and-performance-of-haemostasis-laboratories/. Accessed September 16, 2021.
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