Turkiye Klinikleri Journal of Anesthesiology Reanimation

.: REVIEW
The SARS-CoV-2 Disease and the Risk of Transfusion Transmission: A Narrative Review
SARS-CoV-2 Hastalığı ve Kan Transfüzyonuyla Bulaş Riski: Bir Literatür Derlemesi
Ülkü Ceren KÖKSOYa, Gizem KAHRAMANb, Güle ÇINARc
aDepartment of Anesthesiology and Reanimation, Ufuk University Faculty of Medicine, Ankara, TURKEY
bDepartment of Anesthesiology and Reanimation, Ankara University Faculty of Medicine, Ankara, TURKEY
cDepartment of Infectious Diseases and Clinical Microbiology, Ankara University Faculty of Medicine, Ankara, TURKEY
Turkiye Klinikleri J Anest Reanim. 2021;19(2):94-9
doi: 10.5336/anesthe.2020-80725
Article Language: EN
ABSTRACT
Emerging infection outbreaks have a deteriorating effect for the blood supply by limiting resources and compromising the safety of transfusion of blood products. The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) which leads to a self-limited upper respiratory disease emerged from China and turned into a pandemic in January 2020. Symptomatic, asymptomatic and recuperative patients can be reservoirs for transmission but their viral load in plasma, serum, or lymphocytes in the incubation period is not known, thus their rate of infectivity remains uncertain. Even though transmission by blood is not detected yet, a solitary case has reported a neonate born to a mother with coronavirus disease-2019 (COVID-19) with elevated antibody levels and abnormal cytokine test results 2 hours after birth, pointing at the possibility of vertical transmission. With the pandemic spreading wider, the number of blood donations from asymptomatic patients keeps rising, resulting in blood transfusions from COVID-19 patients to SARS-CoV-2 free recipients. It is stated that if all the blood donations were tested for SARS-CoV-2 RNA up to 15% of donors in the incubation phase would have to be excluded for carrying viral RNA. Although data suggest that it is not transmissible through transfusion with no confirmed cases of transfusion transmission, presence of SARS-CoV-2 RNA in the donated plasma of asymptomatic patients is still considered to constitute a risk for blood safety for both healthcare personnel and the recipients. Therefore, blood centers and banks are advised to take measure for protection from SARS-COV-2 and to avoid the risk of transmission through transfusion.

Keywords: Severe acute respiratory syndrome-coronavirus-2; blood transfusion
ÖZET
Yeni ortaya çıkan enfeksiyonlara bağlı gelişen salgınlar, kaynakları sınırlandırarak ve kan ürünlerinin transfüzyonunun güvenliğini tehlikeye atarak kan tedarikini bozan bir etkiye sahiptir. Kendini sınırlayan bir üst solunum yolu hastalığına yol açan şiddetli akut solunum yolu sendromu koronavirüs-2 [severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2)], Çin'den ortaya çıktı ve Ocak 2020'de pandemiye dönüştü. Semptomatik, asemptomatik ve iyileşen hastalar bulaş için rezervuar olabilirler ancak inkübasyon periyodunda plazma, serum veya lenfositlerindeki viral yük bilinmemektedir, bu nedenle bu hastaların enfektivite oranları belirsizliğini korumaktadır. Kan yoluyla bulaşma henüz tespit edilmemiş olsa da bir vaka sunumunda, koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)] olan bir anneden doğan ve doğumdan 2 saat sonra yüksek antikor seviyeleri ve anormal sitokin testi sonuçları olan bir yenidoğan bildirilmiş ve dikey bulaş olasılığına işaret etmiştir. Pandeminin yayılmasıyla birlikte, asemptomatik hastalardan kan bağışı sayısı artmaya devam etmekte ve bu da COVID19 hastalarından SARS-CoV-2 bulaşı olmayan alıcılara kan transfüzyonu yapılması ile sonuçlanmaktadır. Tüm kan bağışlarının SARSCoV-2 RNA için test edilmesi durumunda, inkübasyon aşamasındaki donörlerin %15'inin viral RNA taşıdıkları için dışlanmaları gerekeceği belirtilmiştir. Veriler transfüzyon yoluyla bulaş olmayacağını gösterse de ve doğrulanmış bir transfüzyona bağlı bulaş vakası gösterilmemiş olsa da asemptomatik hastaların bağışlanan plazmalarındaki SARS-CoV-2 RNA varlığının, hem sağlık personeli hem de alıcılar için kan güvenliği açısından bir risk oluşturduğu düşünülmektedir. Bu nedenle, kan merkezleri ve bankalara SARS-COV-2'den korunmak için önlem almaları ve transfüzyon yoluyla bulaşma riskinden kaçınmaları önerilir.

Anahtar Kelimeler: Şiddetli akut solunum sendromu-koronavirüs-2; kan transfüzyonu
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30.03.2014

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