The SARS-CoV-2 Disease and the Risk of Transfusion Transmission: A Narrative Review

Abstract

Emerging infection outbreaks have a deteriorating effect for the blood supply by limiting resources and compromising the safety of transfusion of blood products. The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) which leads to a self-limited upper respiratory disease emerged from China and turned into a pandemic in January 2020. Symptomatic, asymptomatic and recuperative patients can be reservoirs for transmission but their viral load in plasma, serum, or lymphocytes in the incubation period is not known, thus their rate of infectivity remains uncertain. Even though transmission by blood is not detected yet, a solitary case has reported a neonate born to a mother with coronavirus disease-2019 (COVID-19) with elevated antibody levels and abnormal cytokine test results 2 hours after birth, pointing at the possibility of vertical transmission. With the pandemic spreading wider, the number of blood donations from asymptomatic patients keeps rising, resulting in blood transfusions from COVID-19 patients to SARS-CoV-2 free recipients. It is stated that if all the blood donations were tested for SARS-CoV-2 RNA up to 15% of donors in the incubation phase would have to be excluded for carrying viral RNA. Although data suggest that it is not transmissible through transfusion with no confirmed cases of transfusion transmission, presence of SARS-CoV-2 RNA in the donated plasma of asymptomatic patients is still considered to constitute a risk for blood safety for both healthcare personnel and the recipients. Therefore, blood centers and banks are advised to take measure for protection from SARS-COV-2 and to avoid the risk of transmission through transfusion.