Roubinian Nareg H, Greene John, Spencer Bryan R, Bravo Marjorie, Bruhn Roberta, Saa Paula, Stone Mars, Custer Brian, Kleinman Steve, Liu Vincent X, Norris Philip J, Busch Michael P
Kaiser Permanente Northern California Division of Research, Pleasanton, California, USA.
Vitalant Research Institute, San Francisco, California, USA.
Transfusion. 2025 Mar;65(3):485-495. doi: 10.1111/trf.18159. Epub 2025 Feb 26.
Despite data supporting the safety of SARS-CoV-2 vaccination, concerns regarding the receipt of blood products from donors previously infected or vaccinated against SARS-CoV-2 persist. We assessed whether transfusions of plasma or platelet products from donors with prior SARS-CoV-2 infection or vaccination were associated with adverse outcomes in patients without COVID-19.
We linked donor SARS-CoV-2 spike and nucleocapsid antibody data and vaccination history to blood products transfused between June 1, 2020 and March 31, 2022. We used logistic regression, adjusting for demographics and comorbidities, to calculate odds ratios and 95% confidence intervals (CI) for posttransfusion thrombosis, increased respiratory requirement, and hospital mortality. Outcomes were assessed as per transfused unit from previously infected or vaccinated donors compared to units from uninfected or unvaccinated donors.
Among 8715 hospitalizations of 7773 transfusion recipients linked to donor SARS-CoV-2 antibody data, there were 251 thromboses, 700 hospitalizations with increased respiratory requirements, and 1443 deaths. Among 15,167 transfused plasma units, 4993 and 1106 were from vaccinated donors and previously infected donors, respectively. Among 19,295 transfused platelet units, 8530 and 1368 were from vaccinated and previously infected donors, respectively. There were no associations between the transfusion of blood products from vaccinated or previously infected donors and thrombosis, increased respiratory requirements, or hospital mortality (all CI including 1). Nor were there associations between the receipt of blood products from recently infected or vaccinated donors or high SARS-CoV-2 antibody titers and adverse outcomes.
Donor SARS-Cov-2 infection and vaccination were not associated with adverse patient outcomes and do not need to be considered in blood allocation.
尽管有数据支持接种新型冠状病毒2（SARS-CoV-2）疫苗的安全性，但对于接受曾感染或接种过SARS-CoV-2疫苗的献血者所提供的血液制品仍存在担忧。我们评估了曾感染或接种过SARS-CoV-2疫苗的献血者所提供的血浆或血小板制品输血是否会给未感染2019冠状病毒病（COVID-19）的患者带来不良后果。
我们将献血者的SARS-CoV-2刺突蛋白和核衣壳抗体数据以及疫苗接种史与2020年6月1日至2022年3月31日期间输注的血液制品相关联。我们使用逻辑回归分析，并对人口统计学和合并症进行调整，以计算输血后血栓形成、呼吸需求增加和医院死亡率的比值比及95%置信区间（CI）。将曾感染或接种过疫苗的献血者所提供的输血单位与未感染或未接种疫苗的献血者所提供的单位进行比较，评估结果。
在与献血者SARS-CoV-2抗体数据相关的7773名输血受者的8715次住院治疗中，有251例血栓形成、700例呼吸需求增加的住院治疗和1443例死亡。在15167个输注的血浆单位中，分别有4993个和1106个来自接种过疫苗的献血者和曾感染过的献血者。在19295个输注的血小板单位中，分别有8530个和1368个来自接种过疫苗和曾感染过的献血者。接种过疫苗或曾感染过的献血者所提供的血液制品输血与血栓形成、呼吸需求增加或医院死亡率之间均无关联（所有CI包括1）。近期感染或接种过疫苗的献血者所提供的血液制品或高SARS-CoV-2抗体滴度与不良后果之间也无关联。
献血者感染SARS-CoV-2和接种疫苗与患者不良后果无关，在血液分配中无需考虑。
