Hong Kong Red Cross Blood Transfusion Service, Hong Kong, China.
State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
Transfus Med. 2023 Aug;33(4):315-319. doi: 10.1111/tme.12981. Epub 2023 Jun 7.
Although no case of COVID-19 transmission through transfusion has been reported, blood transfusion service (BTS) continues to implement pre-donation and post-donation measures to minimise the risk. In year 2022, when local healthcare system was badly impacted by a major outbreak, it opened an opportunity to re-examine the viraemia risk in these asymptomatic donors.
Records were retrieved from blood donors who reported COVID-19 after donation and follow-up was also made for recipients who received their blood. Blood samples at donation were tested for SARS-CoV-2 viraemia by single-tube nested real-time RT-PCR assay designed to detect most SARS-CoV-2 variants including the prevailing delta and omicron variants.
From 1 January to 15 August 2022, the city with 7.4 M inhabitants recorded 1 187 844 COVID-19 positive cases and 125 936 successful blood donations were received. 781 donors reported to the BTS after donation with 701 being COVID-19 related (including close contact and symptoms respiratory tract infection). 525 COVID-19 were positive at the time of call back or follow-up. Of the 701 donations, they were processed into 1480 components with 1073 discarded upon donors' call back. For remaining 407 components, no recipient was found to have adverse event or COVID-19 positive. 510 samples from the above 525 COVID-19 positive donors were available and all tested negative for SARS-CoV-2 RNA.
With the negative SARS-CoV-2 RNA in blood donation samples and follow up data in transfusion recipients, the risk of transfusion transmitted COVID-19 appears negligible. However, current measures remains important in securing blood safety with ongoing surveillance of their effectiveness.
尽管尚未报告 COVID-19 通过输血传播的病例,但输血服务(BTS)仍继续实施献血前和献血后的措施,以将风险降至最低。在 2022 年,当地医疗系统受到一次重大疫情的严重影响,这为重新审视这些无症状供者的病毒血症风险提供了机会。
从报告献血后感染 COVID-19 的献血者中检索记录,并对接受其血液的受血者进行随访。在献血时,使用单管巢式实时 RT-PCR 检测试剂盒检测 SARS-CoV-2 病毒血症,该试剂盒旨在检测大多数 SARS-CoV-2 变体,包括流行的 delta 和 omicron 变体。
从 2022 年 1 月 1 日至 8 月 15 日,拥有 740 万居民的城市记录了 1187844 例 COVID-19 阳性病例,共收到 125936 次成功的献血。781 名献血者在献血后向 BTS 报告,其中 701 例与 COVID-19 相关(包括密切接触者和有症状的呼吸道感染)。在召回或随访时,525 例 COVID-19 呈阳性。在 701 次捐赠中,有 1480 个成分被处理,其中 1073 个在供者召回时被丢弃。对于其余 407 个成分,没有发现受血者发生不良事件或 COVID-19 阳性。在上述 525 例 COVID-19 阳性供者中,有 510 份样本可用,所有样本的 SARS-CoV-2 RNA 检测均为阴性。
由于献血样本中 SARS-CoV-2 RNA 检测为阴性,且在受血者中无输血传播 COVID-19 的证据,因此输血传播 COVID-19 的风险似乎可以忽略不计。然而,在持续监测其有效性的情况下,当前的措施对于确保血液安全仍然很重要。