Blood Banks And Hospitals Advised To Take Precautions To Prevent Transfusion Transmitted Infections (TTIs) Of Coronavirus By Contaminated Blood.
The AABB Transfusion Medicine Board has issued guidelines to all Global Blood Banks and hospitals with regards to how to deal with the current SAR-CoV-2 coronavirus situation and to avoid any possibility of TTIs or Transfusion Transmitted Infections of the coronavirus. To date no such infection has been officially reported worldwide.
The SARS-CoV-2 coronavirus like most viruses can be transmitted through the blood but so far there is no detailed studies to confirm at which exact stages of the disease, does the virus starts manifesting in the blood, a condition known as viraemia or sometimes called RNAaemia (When the RNA strands of the virus is detectable in blood plasma.)
Also there are no studies yet to confirm as to what exact minimum coronavirus viral loads are not detectable by current diagnostics (though for the current PCR based nucleic acid tests, a medical expert from Singapore indicated that at 100 copies per ml and below, the detection sensitivity of the tests are compromised and might render inaccurate results or not ‘pick up’ the virus at all .this again is not confirmed by any research studies).
As to which stages viraemia manifest itself in coronavirus infections at the moment is extremely vague. Some of the studies in Wuhan have only given indications that were not detailed for instance in one study 41 cases of COVID-19 admitted to a hospital in Wuhan,SARS-CoV-2 RNA was detected in blood in only 6/41 (15%) of patients but di dnot mention the exact staging of the disease.(Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020.)
In another study of a familial COVID-19 cluster, viral RNA was detected in the serum of 1 of 5 infected family members, who had symptoms (Chan JF-W, Yuan S, Kok K-H, To KK-W, Chu H, Yang J, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. The Lancet. 2020.)
It is because of this and so many other variables that there is no diagnostic blood tests of yet to test for the coronavirus.
Given that SARS-CoV-2 is a new infectious agent, there is little information on the applicability and validity of any test as a screening test for asymptomatic blood donors, although it will probably be most effective by nucleic acid testing (NAT).
Serology testing will not be as useful in screening asymptomatic or pre-symptomatic donors during the acute phase of infection, as they will not have formed detectable antibodies. NAT testing is costly, and the experience in the USA of introducing NAT testing in certain regions for ZIKA virus is informative – just over 4 million donations were screened by ID-NAT, with 8 reactive donations identified at a cost of $5.3 million US dollars (36). As transfusion-transmission has not been demonstrated and there is no licensed test that can be scaled up to screen blood donors, options for testing are premature. Testing for SARS-CoV-2 is also not consistent with blood safety measures taken for other respiratory transmitted.
The Asia Pacific Blood network has also issued guidelines for blood banks and hospitals. (https://apbnonline.com/images/apbn%20rapid%20brief%20white%20paper%202019%20novel%20coronavirus%20sars-cov-2.pdf
On a another note, a team of medical lawyer have advised patients having to undergo any blood transfusions in hospitals to requests for coronavirus test done and documented prior to having any transfusions so as to be able to legally sue the hospital and blood banks should they contract coronavirus infections as a result of contaminated blood stocks.
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