Vitalant Medical Affairs, Scottsdale, Arizona, USA.
Department of Pathology, University of NM School of Medicine, Albuquerque, New Mexico, USA.
Transfusion. 2021 May;61(5):1389-1393. doi: 10.1111/trf.16320. Epub 2021 Feb 20.
COVID-19 safety measures and possibly SARS-CoV-2 antibody testing may alter blood donor demography, which has the potential to alter blood safety. We characterized pre-pandemic and pandemic rates of donor infectious disease marker (IDM) reactivity which reflect the residual risk of transfusion-transmitted infections (TTIs) undetectable by current testing.
This cross-sectional analysis of allogeneic blood donor presentations and successful donations in a large national US blood collector identifies changes in self-reported behavioral risk factors and IDM reactivity. Data on allogeneic blood donor presentations and successful donations from March 1 through August 31, 2020 and the same period in 2019 were retrieved from the blood center's computer system. Donor demographics and deferrals for reported behavioral risk factors and confirmed-positive IDMs were compared in pre-pandemic and pandemic periods.
With increasing mobile blood drive cancellations, pandemic donors were more likely than 2019 donors to be female, over age 30, non-Hispanic Whites, and have a post-secondary degree. First-time donations (at highest risk for confirmed-positive IDMs) did not substantially increase. Pandemic donors reported fewer behavioral risks and IDMs declined among these donors. Mid-pandemic introduction of screening for SARS-CoV-2 antibodies did not affect IDM rates.
Unlike disasters, which tend to bring out more first-time donors with increased IDM reactivity and TTI residual risk, COVID-19 donors had lower IDM rates which were not affected by SARS-CoV-2 antibody testing. Already-low TTI residual risk is likely to have declined as a result.
COVID-19 安全措施和 SARS-CoV-2 抗体检测可能会改变献血者的人口统计学特征,这有可能改变血液安全。我们描述了大流行前和大流行期间献血者传染病标志物(IDM)反应率,这些标志物反映了当前检测无法检测到的输血传播感染(TTI)的残余风险。
本研究通过对美国一家大型血液采集中心的所有异基因献血者的展示和成功献血进行横断面分析,确定了自我报告的行为风险因素和 IDM 反应性的变化。从血液中心的计算机系统中检索了 2020 年 3 月 1 日至 8 月 31 日和 2019 年同期所有异基因献血者的展示和成功献血数据。比较了大流行前和大流行期间的献血者人口统计学特征和因报告的行为风险因素及确认阳性 IDM 而被推迟的情况。
随着流动采血活动的取消增加,大流行期间的献血者比 2019 年的献血者更有可能是女性、年龄超过 30 岁、非西班牙裔白人,且具有高等教育学历。首次献血(确认阳性 IDM 的风险最高)并未大幅增加。大流行期间的献血者报告的行为风险较少,且这些献血者的 IDM 减少。在大流行中期引入 SARS-CoV-2 抗体筛查并没有影响 IDM 率。
与灾难不同,灾难往往会带来更多的首次献血者,这些献血者的 IDM 反应性和 TTI 残余风险增加,但 COVID-19 献血者的 IDM 率较低,且不受 SARS-CoV-2 抗体检测的影响。因此,TTI 的残余风险可能已经降低。