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This study evaluated SARS-CoV-2 infectivity via blood transfusion using French National Blood Service data. Out of 268 donations investigated, 3 (1.1%) tested positive for SARS-CoV-2 RNA, with all testing negative for anti–SARS-CoV-2 antibodies. The virus could not be isolated from the 3 donations.
In this limited study, SARS-CoV-2 viral RNA levels were low when detected among asymptomatic donors, and the corresponding plasma was not infectious in culture.
– Derrick Tao, MD
This abstract is available on the publisher's site.
Since December 2019, a novel human coronavirus, SARS-CoV-2, has emerged from China where the first cases of COVID-19 were described.1,2 It is the third highly pathogenic coronavirus introduced in humans from animal reservoirs3,4 and has spread worldwide, leading to an unprecedented pandemic. By August 2020, more than 20 million cases have been reported worldwide, including almost 0.8 million deaths. France has reported more than 200 000 cases and 30 000 deaths with an epidemic peak at week 14 (30 March-5 April).5 SARS-CoV-2 is mostly transmitted through airborne droplets,6-8 with a reproduction number (R0) varying between 2.5 and 3.5 before the implementation of control measures.9-11 COVID-19 incubation is short (5.7-5.9 days)12 and mostly asymptomatic or with moderate symptoms, but 20% to 25% of infected individuals develop severe symptoms, some of them needing intensive care.6,13,14 First reported data suggested the presence of SARS-CoV-2 RNAemia in patients with severe symptoms,10,11,15 but not in infected asymptomatic individuals.16,17 However, a Chinese study described 4 of more than 7400 blood donors who had extremely low plasma viral load: 2 remaining asymptomatic and 2 declaring fever after donation.18 Therefore, the question of transmission of SARS-CoV-2 through transfusion became relevant. In the context of the SARS-CoV-2 pandemic, we relied on the French hemovigilance network to investigate the presence of SARS-CoV-2 RNA in the plasma of blood donors reporting COVID-19–like symptoms after donation or in donations involved in recipient-initiated trace-back studies, whenever a patient develop symptoms related to COVID-19 shortly after a blood transfusion. This investigation was conducted in accordance with the Declaration of Helsinki. We also addressed the issue of the infectivity of positive samples using direct and enriched virus culture.