Frequent detection but lack of infectivity of SARS-CoV-2 RNA in presymptomatic, infected blood donor plasma.
Frequent detection but lack of infectivity of SARS-CoV-2 RNA in presymptomatic, infected blood donor plasma.
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DOI：
10.1172/jci159876
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发表时间：
2022-09-01
影响因子：
15.9
通讯作者：
Norris, Philip J.
中科院分区：
文献类型：
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作者：
Saa, Paula;Fink, Rebecca V.;Bakkour, Sonia;Jin, Jing;Simmons, Graham;Muench, Marcus O.;Dawar, Hina;Di Germanio, Clara;Hui, Alvin J.;Wright, David J.;Krysztof, David E.;Kleinman, Steven H.;Cheung, Angela;Nester, Theresa;Kessler, Debra A.;Townsend, Rebecca L.;Spencer, Bryan R.;Kamel, Hany;Vannoy, Jacquelyn M.;Dave, Honey;Busch, Michael P.;Stramer, Susan L.;Stone, Mars;Jackman, Rachael P.;Norris, Philip J.
流感等呼吸道病毒通常不会引起病毒血症;然而，在有轻度和重度症状的COVID-19患者的血液中检测到了SARS-CoV-2。在血液中检测到SARS-CoV-2引起了人们对其在发病机制中的作用以及输血安全问题的质疑。献血者在献血后报告COVID-19的症状或诊断（献血后信息，PDI）在一般人群COVID-19死亡率增加之前或同时发生。来自2，250名报告可能与COVID-19相关的PDI的献血者的血浆样本被检测是否存在SARS-CoV-2 RNA。在2020年底至2021年初，RNA血症的检出率在PDI供体中达到9%-15%的峰值，并在人群中广泛实施疫苗接种后降至约4%。与未检测到RNA血症的受感染供体相比，RNA血症供体报告咳嗽或呼吸急促的可能性高1.2至1.4倍，报告味觉或嗅觉变化的可能性高1.8倍。在来自RNAemic供体的血浆中未检测到感染性病毒;基于这些模型中的检测限，接种允许细胞系产生的RNA阳性血浆中的空斑形成单位（PFU）小于0.7-7/mL，在易感小鼠中产生的RNA阳性血浆中的PFU小于100/mL。这些发现表明，输血极不可能传播SARS-CoV-2感染。
Respiratory viruses such as influenza do not typically cause viremia; however, SARS-CoV-2 has been detected in the blood of COVID-19 patients with mild and severe symptoms. Detection of SARS-CoV-2 in blood raises questions about its role in pathogenesis as well as transfusion safety concerns. Blood donor reports of symptoms or a diagnosis of COVID-19 after donation (post-donation information, PDI) preceded or coincided with increased general population COVID-19 mortality. Plasma samples from 2,250 blood donors who reported possible COVID-19–related PDI were tested for the presence of SARS-CoV-2 RNA. Detection of RNAemia peaked at 9%–15% of PDI donors in late 2020 to early 2021 and fell to approximately 4% after implementation of widespread vaccination in the population. RNAemic donors were 1.2- to 1.4-fold more likely to report cough or shortness of breath and 1.8-fold more likely to report change in taste or smell compared with infected donors without detectable RNAemia. No infectious virus was detected in plasma from RNAemic donors; inoculation of permissive cell lines produced less than 0.7–7 plaque-forming units (PFU)/mL and in susceptible mice less than 100 PFU/mL in RNA-positive plasma based on limits of detection in these models. These findings suggest that blood transfusions are highly unlikely to transmit SARS-CoV-2 infection.