Detection of Severe Acute Respiratory Syndrome Coronavirus 2 RNA in Blood Donations

Evaluating Knowledge, Awareness, and Practices among Pakistani Population regarding COVID-19: An Online Survey-Based Study

Aim The study aims to analyze the knowledge, awareness, and practices among the Pakistani population.

Study Method This is an online survey-based study conducted in July 2020 among the general public of Pakistan. Pretested and structured self-administered questionnaire, designed on Google Forms Inc., was used to collect data. The questionnaire included sociodemographic and measurable coronavirus disease 2019 (COVID-19) knowledge data. Assessments on participants' attitudes and practices toward COVID-19 included questions on transmission, symptoms knowledge, and preventive measures.

Results Among the survey completers (n = 962) 61% (n = 590) were male and 39% (n = 372) were female. The majority of participants is aged 18 to 25 and belonged to Punjab. The participants had moderate knowledge regarding disease origin, clinical features, symptoms, and prevention. A vast majority of participants had good knowledge of symptoms and prevention measurements. A good number of participants were also practicing precautionary measures. The majority of participants utilize media and government authorities as authoritative sources of information. The population was also satisfied with the information given by the government.

Conclusion Participants have moderate knowledge regarding the COVID-19 pandemic, reflected by a positive attitude and safe practices. There are gaps in knowledge of the virus, its origin, and transmission. Rumors affect the psychology of people, which may lead to the worst situation of panic conditions.

SARS-CoV-2 and post-donation information: a one-year experience of the French haemovigilance network

BACKGROUND

There is growing evidence to support the hypothesis that SARS-CoV-2 is probably not transmissible by blood transfusion. In this study, we use the data gathered over one year by the French haemovigilance network on post-donation information related to SARS-CoV-2, and virological investigations on corresponding plasma to explore viral transmission by transfusion.

MATERIALS AND METHODS

Whenever a donor reported COVID-19 symptoms and/or a positive SARS-CoV-2 nasopharyngeal (NP) PCR test, information regarding diagnosis and symptoms was collected using a specific questionnaire, and repository plasmas were screened using the SARS-COV-2 R-GENE^® assay (Biomérieux). RNA sequencing (Sanger and deep sequencing) and virus isolation on Vero E6 cells were applied in plasma from donors testing positive.

RESULTS

We investigated 1,092 SARS-CoV-2-related post-donation information (PDI) reports. PDI donors were younger than the global donor population and donated more often in the Paris region. Sixty-eight percent reported a positive NP real-time (RT)-PCR or antigenic testing and 22% of these also had symptoms at the time of testing. Thirty-seven (3.4%) donations tested positive for SARS-CoV-2 RNA, 11 (30%) were confirmed by another molecular assay, and 7 (19%) by sequencing, confirming low viral level. Most RNAemic blood donors donated in southern regions and in Paris. There was no difference in demographic data or duration parameter between RNAemic and non-RNAemic donors. Duration parameter was determined as the time elapsed between donation and: i) the onset of symptoms; ii) a positive NP RT-PCR; and iii) PDI. Cell culture experiments did not show any infectivity related to RNAemic plasmas.

DISCUSSION

SARS-CoV-2 RNA can be detected in a small fraction of blood donors with PDI, reporting very low levels of RNA. The corresponding plasma is probably not infectious. These findings highlight the value of haemovigilance and PDI to guide blood safety strategies.

Severe Acute Respiratory Syndrome Coronavirus 2 and Blood Safety: An Updated Review

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel human coronavirus first identified in late 2019 and subsequently declared a worldwide pandemic in March 2020. In this review, we provide an overview of the implications of SARS-CoV-2 for blood safety and sufficiency.

Summary

Approximately one-third of SARS-CoV-2 infections are asymptomatic. The reported mean incubation period typically varies from 2 to 11 days, but longer periods up to 22 days have been reported. The blood phase of SARS-CoV-2 appears to be brief and low level, with RNAaemia detectable in only a small proportion of patients, typically associated with more severe disease and not demonstrated to be infectious virus. A small number of presymptomatic and asymptomatic blood phase cases have been reported. Transfusion-transmission (TT) of SARS-CoV-2 has not been reported. Therefore, the TT risk associated with SARS-CoV-2 is currently theoretical. To mitigate any potential TT risk, but more importantly to prevent respiratory transmission in donor centers, blood services can implement donor deferral policies based on travel, disease status, or potential risk of exposure and encourage staff vaccination.

Key Messages

The TT risk of SARS-CoV-2 appears to be low. The biggest risk to blood services in the current COVID-19 pandemic is to maintain the sufficiency of the blood supply while minimizing respiratory transmission of SARS-CoV-2 to donors and staff while donating blood.

The Impact of COVID-19 on Blood Transfusion Services: A Systematic Review and Meta-Analysis

Introduction

While SARS-CoV-2's main transmission route is through respiratory droplets, research has found that viral RNA could be detected in blood samples, causing concerns over the safety of blood donations and blood products. This paper therefore aims to systematically search for studies that have addressed their country's lack of donations and analyse the risk of blood transfusion-transmission. As such, it will answer the question "should blood services focus more on donation vigilance or worry more about the risks of transmission through blood products?"

Methods

38 articles were identified through a systematic review adopting the PRISMA and STROBE guidelines. Meta-analysis was conducted using OpenMeta software.

Results

The average decrease in blood donations was found to be 38%, with some regions showing up to 67% decrease. To assess the risk of actual blood transfusion-transmission, three datasets were analysed. Firstly, the viral load in COVID-19 patients was studied and found to have less than 1% detection rate (ARD = -0.831, 95% -0.963, -0.699). Secondly, the prevalence of finding viral RNA in a pool of donations was nearly -1.503 (ARD = -1.538, -1.468). Lastly, recipients who were given blood products of positive donors were found to be -0.911 (ARD 95% = -1.247, -0.575).

Discussion/Conclusion

Blood centres should focus more on launching initiatives and policies that would increase their countries' blood supply as the virus has no direct threat to blood safety.

Minipool testing for SARS-CoV-2 RNA in United States blood donors

BACKGROUND

SARS-CoV-2 RNA prevalence in blood donors from large geographic areas of high community transmission is limited. We tested residual donor plasma minipools (MPs) to determine SARS-CoV-2 RNAemia prevalence in six United States areas.

STUDY DESIGN/METHODS

Blood donations collected from 7 March 2020 to 25 September 2020 were tested for SARS-CoV-2 RNA (vRNA) in MP of 6 or 16 donations using the Grifols Procleix SARS-CoV-2 research-use only (RUO) transcription-mediated amplification (TMA) assay. Reactive results were confirmed using an alternate target region TMA assay. Reactive MPs were tested by TMA after serial dilution to estimate viral load. Testing for anti-SARS-CoV-2 antibodies and infectivity was performed.

RESULTS

A total of 17,995 MPs corresponding to approximately 258,000 donations were tested for vRNA. Three confirmed reactive MP16 were identified. The estimated prevalence of vRNA reactive donations was 1.16/100,000 (95% CI 0.40, 3.42). The vRNA-reactive samples were non-reactive for antibody, and the estimated viral loads of the (presumed single) positive donations within each MP ranged from <1000 to <4000 copies/ml. When tested, no infectivity was observed in inoculated permissive cell cultures.

DISCUSSION

Blood donation MP-nucleic acid testing (NAT) indicated that SARS-CoV-2 RNAemia is infrequent and, when detected, the vRNA was at low concentrations. Only one RNA-reactive MP could be tested for infectivity for operational reasons and was not infectious in cell culture. These findings support current recommendations from international and national regulatory agencies to not screen donors by NAT.

COVID-19 pandemic and transfusion medicine: the worldwide challenge and its implications

COVID-19 pandemic has imposed worldwide challenge and has significantly affected transfusion medicine. Shortage in blood products along with concerns regarding the safety of blood products have emerged. Measures to overcome these challenges have been implemented in order to decrease the demand on blood products and to encourage blood donations while taking full precautions to minimize risk of COVID-19 transmission mainly at blood banks and medical centers. Several countries have been successful in facing these new challenges. In addition, the role of plasma therapy in the treatment of COVID-19 patients, especially in severe cases, has been proposed and current studies are being conducted to determine its efficacy. Other therapeutic options are currently being explored. So far, the use of convalescent plasma is considered a promising rescue treatment to be looked at.