Blood supply and transfusion safety during the COVID-19 pandemic

Abstract

Introduction: The COVID-19 pandemic has put a strain on transfusion practices and safety. The Scientific Committees consider that the COVID-19 pandemic presents a potential risk of reducing and compromising the blood product supply and expressed considerable concern about transfusion safety. Method: In this concise review, we provide an overview of the implications of COVID-19 for blood safety and sufficiency during the initial phases of the pandemic. We searched the PubMed database, the websites of the World Health Organization, the European Centre for Disease Prevention and Control, the US Communicable Diseases Center. We used the keywords COVID-19, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the impact of COVID-19 on the blood supply, impact of COVID-19 on blood collection, COVID-19 and transfusion safety, the transmission of SARS-CoV-2 through blood transfusion, COVID-19 symptoms, asymptomatic blood donor, COVID-19 patients. Results: Data provided from blood transfusion centers and blood banks worldwide show that the COVID-19 pandemic has affected the activities of the blood supply system. It has impacted blood collections and caused a significant decrease in blood donors. The estimated asymptomatic infection rate was 15–46% of SARS-CoV-2 infections. The estimated incubation ranges are between 2 and 11 days, and almost all infections developed symptoms by day 14. The RNAemia phase of SARS-CoV-2 appears to be brief and low level, is typically associated with more severe disease, and is not demonstrated to be an infectious virus. It is detectable in only a tiny proportion of patients. Post-donation, post-transfusion information, and molecular testing of swab samples collected from asymptomatic donors at risk for COVID-19 provided data supporting the absence of transfusion transmission (TT) of COVID-19. The TT risk is currently theoretical. To prevent and minimize respiratory transmission of SARS-CoV-2 to donors and staff while donating blood, blood centers have had to activate their emergency plans and propose appropriate response measures. Conclusion: The COVID-19 pandemic has a significant impact on blood transfusion activities worldwide. The risk of transmission of COVID-19 through transfusion of blood collected from asymptomatic individuals is now only theoretical and likely minimal. Blood systems should adopt a national approach for coherence and coordination to ensure public confidence in blood safety and supply.