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Introduction Acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19) often leads to mortality. Outcomes of patients with COVID-19-related ARDS compared to ARDS unrelated to COVID-19 is not well characterized. Areas covered We performed a systematic review of PubMed, Scopus, and MedRxiv 11/1/2019 to 3/1/2021, including studies comparing outcomes in COVID-19-related ARDS (COVID-19 group) and ARDS unrelated to COVID-19 (ARDS group). Outcomes investigated were duration of mechanical ventilation-free days, intensive care unit (ICU) length-of-stay (LOS), hospital LOS, and mortality. Random effects models were fit for each outcome measure. Effect sizes were reported as pooled median differences of medians (MDMs), mean differences (MDs), or odds ratios (ORs). Expert opinion Ten studies with 2,281 patients met inclusion criteria (COVID-19: 861 [37.7%], ARDS: 1420 [62.3%]). There were no significant differences between the COVID-19 and ARDS groups for median number of mechanical ventilator-free days (MDM: −7.0 [95% CI: −14.8; 0.7], p = 0.075), ICU LOS (MD: 3.1 [95% CI: −5.9; 12.1], p = 0.501), hospital LOS (MD: 2.5 [95% CI: −5.6; 10.7], p = 0.542), or all-cause mortality (OR: 1.25 [95% CI: 0.78; 1.99], p = 0.361). Compared to the general ARDS population, results did not suggest worse outcomes in COVID-19-related ARDS.

Objectives: To systematically review the clinical literature reporting the use of Lopinavir/ritonavir (LPV/r) for the treatment of patients with Cornonavirus disease 19 (COVID-19) to assess the efficacy of LPV/r for the treatment of COVID-19. Methods: The authors systematically searched PubMed and MedRxiv databases for studies describing treatment of COVID-19 patients using LPV/r compared to other therapies. Articles were excluded if they were case reports, opinion editorials, preclinical studies, single-armed studies, not written in English, not relevant to the topic, or published before May 2020. The included outcomes were viral clearance as measured by reverse-transcription polymerase chain reaction (RT-PCR) negativity and/or improvement on chest computed tomography (CT), mortality, and adverse events. Results: Among 858 total studies, 16 studies met the inclusion criteria and were included in the qualitative review. These studies consisted of 3 randomized control trials, 3 open-label trials, and 10 observational studies. Most of these studies did not report positive clinical outcomes with LPV/r treatment. Conclusion: The systematic review revealed insufficient evidence of effectiveness and clinical benefit of LPV/r in the treatment of COVID-19 patients. Specifically, LPV/r does not appear to improve clinical outcome, mortality, time to RT-PCR negativity, or chest CT clearance in patients with COVID-19.

Blood bank medical coverage can be daunting to both the practicing general pathologist and the pathology resident in training. Even for the blood bank specialist physician, decisionmaking on call can be stressful. The blood bank is somewhat unique among the clinical laboratories in that many of the issues that arise after-hours and on weekends are urgent, if not lifethreatening, and involve therapeutic measures in addition to diagnostic testing. Blood bank decisions may also require more clinical information than was provided with the blood sample received. The transfusion medicine physician must often review patient charts or laboratory results from other divisions of the laboratory, as well as discuss the patient condition with the ordering physician. Thus, blood bank medical practice can be more clinically focused and interactive than some of the other laboratory specialties. This review will cover some of the more common situations that arise that involve the pathologist in the blood bank after hours. Most decisions can be divided into component selection issues and testing issues. Table 1 lists some of the common situations in each category. Almost by definition, if the decision must be made after regular on site medical staffing hours, the decision is urgent in nature. Therefore, these decisions carry an increased level of stress and the need to possess certain knowledge, experience, or other resources to make a timely decision.

We report two pediatric patients with rifampin-induced hemolysis following treatment with low daily dose rifampin for methicillin-resistant Staphylococcus aureus (MRSA). With the increased use of rifampin to treat MRSA, physicians should be aware that patients receiving rifampin therapy are at risk for hemolysis, even at low daily doses. Pediatr Blood Cancer 2008;51:821–823. © 2008 Wiley-Liss, Inc.

In patients with rare factor deficiencies, for which no factor concentrates are available, plasma exchange (PE) is an option for raising the desired factor level to approximately 80% for surgery. We report a case of acquired factor X (FX) deficiency due to amyloidosis that required urgent surgical repair of an AV fistula aneurysm. This patient had a FX level of 3% at presentation; after 1.5 volume PE with fresh frozen plasma (FFP), his post-exchange FX was only 5%, indicating rapid adsorption of FX to amyloid fibrils. He was managed successfully with FEIBA during surgery.

Background: Transplantation of hematopoietic progenitor cells is widely used to ameliorate the consequences of bone marrow failure. In allogeneic transplantation, peripheral blood progenitor cells (PBPCs) from an HLA-matched donor are collected by apheresis and then identified using flow cytometric methods as being CD34 marker positive cells. Case Report: A 25-year-old healthy male was matched with an obese 106 kg 23-year-old female diagnosed with acute lymphoblastic lymphoma. After a routine course of G-CSF induction, a 2-day PBPC collection procedure with a collection volume of 12 L/day was planned. All samples for CD34 estimation were shipped, stored, and tested according to the laboratory standard regulations. Testing was performed per International Society for Hematotherapy and Graft protocol, and CD34+ cells were immunophenotyped using monoclonal antibody against CD34 and CD45 by multicolor flow cytometry. Results: The cumulative yield of both collections was 70.6 × 106 CD34+ cells (0.67 × 106 CD34+ cells/kg), which fell short of the requested dose of 530 × 106 (5 × 106 CD34+ cells/kg). Surprisingly, the recipient engrafted successfully and 12 days posttransplant short tandem repeat testing demonstrated only T cells of donor origin in the peripheral blood. Conclusion: To our knowledge, no successful engraftment has been reported as yet with such a poor collection of PBPC. The amountof transfused CD34+ cells (0.67 × 106/kg) was significantly less than the minimum required amount (5× 106/kg). J. Clin. Apheresis, 2009. © 2009 Wiley-Liss, Inc.